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Growth of preterm infants fed nutrient-enriched or term formula after hospital discharge
1University of South Florida College of Medicine, Department of Pediatrics, Division of Neonatology, Tampa, Florida 33606, USA. jcarver@med.usf.edu
Insights
Nutrient-enriched postdischarge formula (PDF) improved growth in preterm infants up to 12 months corrected age. Benefits were most significant for head circumference in infants with lower birth weights (<1250 g).
Area of Science:
- Neonatal nutrition
- Pediatric growth and development
- Clinical nutrition research
Background:
- Preterm infants often have suboptimal nutrient stores and energy deficits at hospital discharge.
- Bone mineralization can be deficient in premature infants post-discharge.
- Accrued energy deficits pose challenges for optimal infant growth.
Purpose of the Study:
- To evaluate the growth of premature infants fed a nutrient-enriched postdischarge formula (PDF) versus a standard term-infant formula (TF).
- To compare growth outcomes up to 12 months corrected age (CA) in preterm infants.
- To identify specific benefits of PDF for subgroups of preterm infants.
Main Methods:
- Double-blind, randomized study of preterm infants with birth weights <1800 g.
- Comparison of 22 kcal/fl oz PDF with 20 kcal/fl oz TF from hospital discharge to 12 months CA.
- Growth assessed using analysis of variance, controlling for site, feeding, gender, and birth weight; interaction effects analyzed.
Main Results:
- Infants fed PDF showed greater weight at 1-2 months CA and length at 3 months CA compared to TF.
- Significant benefits of PDF on weight, length, and head circumference were observed in infants with birth weights <1250 g.
- PDF-fed infants had larger head circumferences at multiple time points and consumed less formula with higher protein intake.
Conclusions:
- Nutrient-enriched postdischarge formula (PDF) significantly improved growth in preterm infants up to 12 months corrected age.
- The most pronounced benefits of PDF were seen in head circumference growth for infants with birth weights <1250 g.
- PDF appears particularly beneficial for the growth of vulnerable preterm infants, especially males.
Objective:
At hospital discharge, preterm infants may have low body stores of nutrients, deficient bone mineralization, and an accumulated energy deficit. This double-blind, randomized study evaluated the growth of premature infants with birth weights <1800 g who were fed a 22 kcal/fl oz nutrient-enriched postdischarge formula (PDF) or a 20 kcal/fl oz term-infant formula (TF) from hospital discharge to 12 months' corrected age (CA).
Methods:
Infants were randomized to PDF or TF a few days before hospital discharge with stratification by gender and birth weight (<1250 g or >/=1250 g). The formulas were fed to 12 months' CA. Growth was evaluated using analysis of variance controlling for site, feeding, gender, and birth weight group. Interaction effects were also assessed. Secondary analyses included a repeated measures analysis and growth modeling.
Results:
One hundred twenty-five infants were randomized; 74 completed to 6 months' CA and 53 to 12 months' CA. PDF-fed infants weighed more than TF-fed infants at 1 and 2 months' CA, gained more weight from study day 1 to 1 and 2 months' CA, and were longer at 3 months' CA. There were significant interactions between feeding and birth weight group-among infants with birth weights <1250 g, those fed PDF weighed more at 6 months' CA, were longer at 6 months' CA, had larger head circumferences at term 1, 3, 6, and 12 months' CA, and gained more in head circumference from study day 1 to term and to 1 month CA. The repeated measures and growth modeling analyses confirmed the analysis of variance results. The PDF formula seemed to be of particular benefit for the growth of male infants. Infants fed the PDF consumed less formula and had higher protein intakes at several time points. Energy intakes, however, were not different.
Conclusions:
Growth was improved in preterm infants fed a nutrient-enriched postdischarge formula after hospital discharge to 12 months' CA. Beneficial effects were most evident among infants with birth weights <1250 g, particularly for head circumference measurements.
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