Introducing enteral feeds in the high-risk preterm infant

Area of Science:

• Neonatalogy
• Pediatric Nutrition
• Gastroenterology

Background:

• Very preterm infants face challenges in nutrient absorption due to immature gut and metabolic functions.
• Parenteral nutrition is crucial in early weeks while the infant gut adapts.
• Imbalances in intestinal function, nutrition, and microbiota can lead to necrotising enterocolitis.

Purpose of the Study:

• To outline strategies for establishing enteral feeding in high-risk, very preterm infants.
• To emphasize the role of breast milk and appropriate fortification in preterm infant nutrition.
• To highlight the importance of optimizing nutrient intake to prevent extrauterine growth restriction.

Main Methods:

• Review of current practices in neonatal nutrition and enteral feeding.
• Discussion of the physiological adaptations of the preterm gut.
• Emphasis on the use of mother's breast milk as the primary nutrition source.

Main Results:

• Early introduction of small enteral feeding volumes is not detrimental.
• Gradual advancement of enteral feeds is tolerated as gut function improves.
• Supplementation and fortification of breast milk are key to meeting nutritional needs.

Conclusions:

• Optimizing enteral feeding, prioritizing breast milk, is essential for preterm infants.
• Careful monitoring and adjustment of feeding regimens can mitigate risks like necrotising enterocolitis.
• Adequate nutrition is vital to minimize extrauterine growth restriction in this vulnerable population.