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Nutrient requirements for preterm infant formulas
1Life Sciences Research Office, 9650 Rockville Pike, Bethesda, Maryland 20814, USA. cklein@lsro.faseb.org
Insights
Specialized infant formulas are crucial for the growth of preterm and low birth weight (LBW) infants. This study provides updated recommendations for nutrient content in preterm infant formulas to ensure optimal development.
Area of Science:
- Nutritional Science
- Neonatology
- Pediatric Gastroenterology
Background:
- Preterm and low birth weight (LBW) infants face challenges in growth and nutrient absorption due to physiological immaturity.
- Advances in neonatal care and nutrition have significantly reduced mortality rates in these vulnerable infants.
- The Food and Drug Administration (FDA) oversees the safety and nutritional quality of infant formulas.
Purpose of the Study:
- To establish evidence-based recommendations for the nutrient composition of specialized formulas for preterm and LBW infants.
- To update guidelines based on current scientific knowledge and expert consensus.
- To address the unique nutritional needs of preterm infants, differing from term infants.
Main Methods:
- An ad hoc Expert Panel, convened by the Life Sciences Research Office of the American Society for Nutritional Sciences under FDA contract, developed the recommendations.
- Consideration was given to intrauterine accretion rates, organ development, and factorial estimates of requirements.
- Data from nutrient interactions, supplemental feeding studies, and long-term developmental outcomes were evaluated.
Main Results:
- Recommendations were formulated for energy and 45 nutrient components in enteral formulas for preterm-LBW infants.
- Specific recommendations were made for nutrients not typically required in term infant formulas, such as lactose and arginine.
- Guidelines were based on a standardized model of a 1000 g preterm infant with specific intake parameters.
Conclusions:
- The study presents comprehensive recommendations for enteral formulas tailored to preterm and LBW infants.
- Identified critical areas for future research to further refine nutritional requirements for this population.
- These updated guidelines aim to support appropriate growth and nutrient accretion in hospitalized preterm infants.
Abstract:
Achieving appropriate growth and nutrient accretion of preterm and low birth weight (LBW) infants is often difficult during hospitalization because of metabolic and gastrointestinal immaturity and other complicating medical conditions. Advances in the care of preterm-LBW infants, including improved nutrition, have reduced mortality rates for these infants from 9.6 to 6.2% from 1983 to 1997. The Food and Drug Administration (FDA) has responsibility for ensuring the safety and nutritional quality of infant formulas based on current scientific knowledge. Consequently, under FDA contract, an ad hoc Expert Panel was convened by the Life Sciences Research Office of the American Society for Nutritional Sciences to make recommendations for the nutrient content of formulas for preterm-LBW infants based on current scientific knowledge and expert opinion. Recommendations were developed from different criteria than that used for recommendations for term infant formula. To ensure nutrient adequacy, the Panel considered intrauterine accretion rate, organ development, factorial estimates of requirements, nutrient interactions and supplemental feeding studies. Consideration was also given to long-term developmental outcome. Some recommendations were based on current use in domestic preterm formula. Included were recommendations for nutrients not required in formula for term infants such as lactose and arginine. Recommendations, examples, and sample calculations were based on a 1000 g preterm infant consuming 120 kcal/kg and 150 mL/d of an 810 kcal/L formula. A summary of recommendations for energy and 45 nutrient components of enteral formulas for preterm-LBW infants are presented. Recommendations for five nutrient:nutrient ratios are also presented. In addition, critical areas for future research on the nutritional requirements specific for preterm-LBW infants are identified.