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Published on: December 16, 2015
Considerations and approaches in determining the protein and energy composition of preterm infant formulas
Silvia Fanaro1, Gloria Cristofori, Fabio Mosca
1Neonatal Intensive Care Unit, Department of Clinical and Experimental Medicine, University of Ferrara, Italy. fnrslv@unife.it
Insights
Providing optimal early nutrition for preterm infants, especially those with very low birth weight, is challenging due to medical issues and inadequate formulas. Current preterm formulas need improvement to meet specific infant nutritional needs for healthy weight gain.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
Background:
- Optimal early nutritional support is critical for preterm infants, particularly those with very low or extremely low birth weight.
- Current nutritional delivery is often inadequate due to factors like hypoxia, acidosis, and reduced intestinal motility.
- Concerns exist regarding metabolic and intestinal tolerance of suggested intakes and a lack of standardized nutritional programs.
Purpose of the Study:
- To highlight the challenges in achieving optimal early nutritional support for preterm infants.
- To identify deficiencies in currently available preterm formulas.
- To propose improvements in preterm infant nutrition strategies.
Main Methods:
- Review of current literature on preterm infant nutrition.
- Analysis of factors affecting nutritional delivery and tolerance.
- Evaluation of preterm formula composition in relation to infant needs.
Main Results:
- Several medical conditions impede adequate nutritional delivery in preterm infants.
- Existing preterm formulas often have inadequate protein content and inappropriate protein-to-energy ratios.
- There is a direct correlation between formula composition and infant weight gain quality and quantity.
Conclusions:
- Current preterm formulas are largely inadequate for the real nutritional needs of preterm infants.
- Improved formula composition, specifically protein content and energy ratio, is essential.
- Distinct formulas are needed for different preterm infant weight categories (LBW/VLBW and >1500g).
Abstract:
Optimal early nutritional support is considered a crucial issue in the care of the preterm infant, particularly of those with very low- or extremely low-brithweight. Unfortunately, this goal is seldom satisfactorily attained. Several conditions such as hypoxia, acidosis, patent ductus arteriosus, drug therapy, reduced intestinal motility may interfere with an adequate nutritional delivery in the early neonatal period. Moreover, there is still concern about metabolic and intestinal tolerance of the currently suggested intakes and a lack of uniformity in the nutritional program among different NICUs. Finally, the vast majority of the available preterm formulas are not fully adequate to the real nutritional needs of these infants. Inadequate protein content and inappropriate protein energy ratio of most preterm formulas represent a matter of major concern, since there is a strict relationship between formula composition and the quantity and quality of weight gain. As a consequence there is a need of at least two milk formulas for different preterm infants: one for LBW and VLBW infants, the other for preterm infants weighing >1500 g.
