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Adiposity is not altered in preterm infants fed with a nutrient-enriched formula after hospital discharge
Richard J Cooke1, Ian J Griffin, Kenny McCormick
1Department of Pediatrics, Cardinal Glennon Children's Hospital, St Louis, Missouri 63104, USA. richardjcooke@mac.com
Insights
Nutrient-enriched formula for preterm infants promoted catch-up growth, increasing total and peripheral fat mass without altering adiposity. This supports improved body composition in these vulnerable infants.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Growth and Development
Background:
- Preterm infants often experience growth deficits.
- Nutritional strategies aim to optimize growth and body composition post-discharge.
- Concerns exist regarding potential effects of specialized formulas on infant adiposity.
Purpose of the Study:
- To evaluate the impact of different post-discharge feeding regimens on body size and composition in preterm infants.
- To determine if nutrient-enriched formulas influence adiposity in preterm infants.
- To compare growth outcomes between preterm infants fed nutrient-enriched, term, or breast milk formulas.
Main Methods:
- Dual energy x-ray absorptiometry (DXA) was used to assess body composition.
- Infants were divided into four feeding groups: nutrient-enriched, term infant formula, combined, and breast-fed.
- Measurements were taken at hospital discharge and at 3, 6, and 12 months corrected age.
Main Results:
- All infants demonstrated "catch-up" growth.
- Infants receiving nutrient-enriched formula (Group A) showed greater weight and length compared to other groups.
- Increased catch-up growth correlated with higher total and peripheral fat mass, particularly in the legs, but not increased fat percentage.
Conclusions:
- Nutrient-enriched formulas support rapid and complete catch-up growth in preterm infants.
- This enhanced growth is associated with increased lean mass and peripheral fat accretion, not central or overall adiposity.
- Current data do not support concerns of increased adiposity with post-discharge nutrient-enriched feeding in preterm infants.
Abstract:
To determine whether adiposity was altered, body size (weight, length) and composition, determined by dual energy x-ray absorptiometry, were examined in preterm infants fed with a nutrient enriched (A, n=56), a term infant (B, n=57) or the nutrient enriched (discharge and term) plus the term formula (term and 6 mo; C, n=26), and a group of breast-fed preterm infants (D, n=25) at hospital discharge, 3, 6, and 12 mo corrected age. The results were analyzed using standard statistics. One hundred sixty-four infants (birth weight=1406+/-248 g, GA=31+/-1.7 wk) were studied. All infants underwent "catch-up," but weight and length were greater in infants in group A compared with groups B, C, or D. More rapid and complete "catch-up" was paralleled by increased total nonfat and fat mass (g) but not percentage of fat mass. Changes in fat mass (g) were primarily explained by increased fat accretion on the legs. More rapid and complete "catch-up" growth, therefore, reflected increased nonfat and peripheral fat mass. These data do not support the hypothesis of increased or central adiposity in infants fed a nutrient-enriched formula after hospital discharge.
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