Aggressive nutrition for preterm infants--benefits and risks

Area of Science:

• Neonatal nutrition
• Perinatal medicine
• Pediatric growth and development

Background:

• Very preterm infants frequently exhibit growth failure in neonatal intensive care units.
• Recent guidelines emphasize fetal growth references for protein and energy, increasing recommended protein intake.

Purpose of the Study:

• To outline strategies for optimizing nutrition in very preterm infants to prevent growth failure.
• To align nutritional support with revised guidelines for protein and energy requirements.

Main Methods:

• Initiating parenteral nutrition (PN) with high protein and lipid content on day one.
• Administering minimal enteral feeds (5-20 ml/kg/day) concurrently with PN, gradually increasing volume.
• Prioritizing mother's own milk and adjusting fortification to meet new guidelines.

Main Results:

• Early PN and carefully advanced enteral feeds are crucial for limiting growth failure.
• Revised fortification schedules for human milk are necessary to meet updated nutritional targets.
• This approach aims to improve infant growth, neurodevelopment, and reduce infection rates.

Conclusions:

• Optimizing nutritional strategies, including early PN and tailored enteral feeding with fortified human milk, is essential for very preterm infants.
• Adherence to revised protein and energy guidelines can mitigate growth failure and associated complications.
• This integrated approach supports better outcomes, including reduced infection risk and avoidance of catch-up growth issues.