Short- and long-term effects of individualized enteral protein supplementation in preterm newborns

Area of Science:

• Neonatology
• Pediatric Nutrition
• Developmental Pediatrics

Background:

• Preterm infants (gestational age ≤32 weeks) require specialized nutrition.
• Standard feeding protocols may not always meet the protein needs of preterm infants.
• Assessing the necessity and impact of additional protein is crucial for optimizing growth and development.

Purpose of the Study:

• To evaluate the need for extra enteral protein in preterm infants after achieving full enteral feeds.
• To determine the effects of additional protein on physical growth and neurodevelopmental outcomes.
• To compare outcomes between supplemented and non-supplemented preterm infants.

Main Methods:

• Retrospective study of preterm infants (GA ≤32 weeks).
• Assessment of protein requirements based on serum BUN/prealbumin levels post-enteral feeding.
• Supplementation provided based on specific biochemical markers (BUN <5 mg/dl and/or prealbumin ≤8 mg/dl).
• Evaluation of NICU growth and neurodevelopmental outcomes at 18 months corrected age.

Main Results:

• Infants receiving additional protein (Group 2, n=33) showed improved weight gain and head growth compared to the non-supplemented group (Group 1, n=32).
• Higher Bayley scores at 18 months corrected age were observed in the supplemented group.
• All infants in the supplemented group were fed fortified breast milk.

Conclusions:

• Standard fortified breast milk may be insufficient for optimal preterm infant nutrition.
• Additional enteral protein supplementation can enhance physical growth in the NICU.
• Supplementation appears to lead to better neurodevelopmental outcomes at 18 months corrected age.