Optimal growth of preterm infants

Area of Science:

• Neonatology
• Pediatric Nutrition
• Growth and Development

Background:

• Infant growth restriction in preterm neonates is multifactorial, with nutrition accounting for approximately 50% of early postnatal growth variance.
• Infants born small-for-gestational age (SGA) are at the highest risk for growth restriction and may have unique nutritional requirements.
• Neonatal nutrition significantly impacts both short- and long-term outcomes in preterm infants.

Purpose of the Study:

• To highlight the critical role of neonatal nutrition in preterm infant outcomes.
• To discuss the challenges in monitoring postnatal growth and assessing growth quality.
• To explore the potential of noninvasive body composition methods for evaluating nutritional interventions.

Main Methods:

• Review of current understanding of neonatal nutrition and its impact on preterm infant growth.
• Discussion of limitations in existing growth monitoring charts and methods.
• Exploration of advanced techniques like air displacement plethysmography for body composition assessment.

Main Results:

• Nutrition is a primary determinant of early postnatal growth variance in preterm infants.
• Rapid postnatal weight gain, while beneficial for neurodevelopment, may increase risks of insulin resistance and metabolic syndrome.
• Current growth charts reflect practices rather than optimal growth, complicating monitoring.

Conclusions:

• Minimizing postnatal growth failure may reduce the need for catch-up growth, thereby lowering cardiovascular risk factors.
• Accurate assessment of postnatal growth quality requires considering factors beyond body weight, such as lean body mass and length.
• Further validation of methods like air displacement plethysmography is needed for preterm neonates to improve nutritional strategies.