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Growth and nutrition after discharge
1MRC Childhood Nutrition Research Centre, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. m.fewtrell@ich.ucl.ac.uk
Abstract:
Preterm infants are frequently discharged from hospital growth retarded and show reduced growth during childhood. However, nutrition during the post-discharge period has been neglected. Randomized trials show growth benefits, particularly in boys, when nutrient-enriched diets (preterm formula or post-discharge formula) rather than term formula are fed after discharge, with effects persisting beyond the intervention period. These findings suggest that post-discharge period may be a critical time for influencing the growth trajectory, but further research is required to investigate longer-term effects on growth, health and development. Preterm infants who are breast-fed after discharge show slower weight and length gain and lower bone mass than formula-fed infants. Further studies should establish whether differences persist or have long-term consequences, and clarify whether such infants would benefit from post-discharge nutritional supplementation. The introduction of solids may have a significant effect on growth and nutritional status, but insufficient data are currently available for evidence-based guidelines.