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Growth of very low birth weight infants after increased amino acid and protein administration

Andrea Loui, Christoph Bührer

    Journal of Perinatal Medicine
    |August 17, 2013
    PubMed

    Insights

    High protein nutrition in human milk-fed very low birth weight infants supports growth similar to fetal development. This strategy significantly impacts infant weight gain in the first five weeks of life.

    Area of Science:

    • Neonatal nutrition
    • Pediatric growth studies
    • Human milk fortification

    Background:

    • Very low birth weight (VLBW) infants (<1500 g) require specialized nutritional support for optimal growth.
    • Human milk is the preferred nutrition source, but often needs fortification for VLBW infants.
    • Assessing high protein strategies is crucial for achieving near-intrauterine growth in VLBW infants.

    Purpose of the Study:

    • To evaluate the effect of a high enteral protein nutrition strategy on the growth of human milk-fed VLBW infants.
    • To determine the impact of protein intake on weight gain during the initial five weeks of life.

    Main Methods:

    • A cohort of 43 VLBW infants (gestational age 27+6 weeks, birth weight 984 g) was studied.
    • Infants received parenteral nutrition for a median of 16 days, with target intakes of 4.3 g/kg/day protein and 128 kcal/kg/day energy.
    • Human milk was fortified with additional protein powder (0.5-2.3 g/kg/day).

    Main Results:

    • Near-intrauterine growth was observed, with significant weight gain (17.6 g/kg/day), head growth (0.70 cm/week), and length growth (1.0 cm/week) from days 8-35.
    • Total protein intake demonstrated a significant positive impact on infant weight gain up to day 35.
    • Nutritional targets for protein and energy were successfully achieved.

    Conclusions:

    • High protein nutrition in VLBW infants fed human milk promotes growth comparable to fetal development during the first five weeks.
    • The findings support recent European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recommendations for VLBW infant nutrition.
    • This strategy is effective in supporting adequate weight and head growth in this vulnerable population.
    Abstract

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