Protein and energy requirements in preterm infants

Although protein and energy requirements in healthy growing and enterally fed infants are relatively well established, the nutritional requirements of extremely low birth weight infants are considerably less certain. New and emerging data in ELBW infants suggest high rates of energy expenditure and protein losses, which results in significant nutritional deficits and high rates of growth failure. Based on the limited and incomplete available data, energy intakes of 125-130 kcal/kg/d and protein intakes of 3.5-4 g/kg/d appear to be necessary to produce normal growth in ELBW infants. Although these intakes may be difficult to achieve in clinical practice, there is clear evidence that aggressive early nutrition can improve growth outcomes in these infants.