Posthospital discharge feeding for preterm infants: effects of standard compared with enriched milk formula on growth, bone mass, and body composition
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Published on: February 15, 2018
Winston W K Koo1, Elaine M Hockman
1Carman and Ann Adams Department of Pediatrics, Wayne State University and Hutzel Hospital, Detroit, MI 48201, USA. wkoo@wayne.edu
Insights
Nutrient-enriched formula (EF) did not improve growth or body composition in preterm infants post-discharge compared to standard term formula (TF). Further research is needed for optimal nutrition support in preterm infants.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Growth and Development
Background:
- Post-discharge nutrition for preterm infants is crucial for growth.
- The efficacy of nutrient-enriched formulas (EF) versus term formulas (TF) is not well-established.
Purpose of the Study:
- To compare the effects of EF and TF on growth, bone mass, and body composition in preterm infants after hospital discharge.
Main Methods:
- A randomized, double-blind study compared EF and TF for one year post-discharge.
- EF had higher energy, protein, calcium, and phosphorus content than TF.
Main Results:
- Infants receiving TF showed significantly greater weight, length, and head circumference z-scores.
- The TF group also exhibited superior bone, lean, and fat mass compared to the EF group.
Conclusions:
- Nutrient-enriched formula offers no apparent benefit over term formula for preterm infant growth post-discharge.
- Optimal post-discharge nutritional strategies for preterm infants require further investigation.
Background:
Despite the theoretical benefits of nutrient-enriched formula given to preterm infants after hospital discharge, its role in reversing growth deficits after hospital discharge remains poorly defined.
Objective:
The aim was to determine the effect of different formulas on the growth, bone mass, and body composition of preterm infants after hospital discharge.
Design:
This was a randomized, double blind comparison of a nutrient-enriched formula (EF) and a formula for term infants (TF) given for 1 y after hospital discharge. Compared with the TF, the EF had a higher energy density and higher contents of protein, calcium, and phosphorus (by 10%, 21%, 44%, and 11%, respectively) and higher contents of almost all other nutrients (by >or=10%).
Results:
Birth weights of the infants were 630-1620 g (median: 1250 g) and gestational ages were 24-34 wk (median: 29 wk). TF resulted in significantly greater weight, length, head circumference measurements, and their respective z scores on the basis of age- and sex-specific norms. At the end of the study, the mean z scores for the corrected age of infants in the TF group were -0.37 for weight, 0.001 for length, and 0.50 for head circumference. The TF group also had significantly greater dual-energy X-ray absorptiometry measured bone and lean and fat mass than did the EF group (P < 0.05 for all comparisons).
Conclusions:
The use of EF for preterm infants after hospital discharge shows no advantage over TF in growth, bone mineralization, and body composition. More studies are needed to determine the optimal postdischarge nutrition support for preterm infants.
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