Nutritional practices and postnatal growth restriction in preterm newborns

Area of Science:

• Neonatalogy
• Pediatric Nutrition
• Intensive Care Medicine

Background:

• Growth retardation is a significant concern for premature infants in the Neonatal Intensive Care Unit (NICU).
• Nutritional practices play a critical role in the growth and development of these vulnerable infants.
• Understanding the association between nutritional strategies and growth outcomes is essential for improving care.

Purpose of the Study:

• To assess the nutritional practices in Neonatal Intensive Care Units (NICUs).
• To evaluate the relationship between these practices and growth retardation in premature infants.
• To identify factors influencing growth and weight gain in very low birth weight neonates.

Main Methods:

• Retrospective study of preterm infants (500-1,499 g) admitted to the NICU.
• Analysis of growth patterns and parenteral (PN) and enteral (EN) nutrition delivery.
• Multivariate analysis to identify risk factors for poor growth outcomes.

Main Results:

• Parenteral nutrition was often initiated late with suboptimal supply levels for glucose, amino acids, lipids, and energy.
• Enteral nutrition onset was timely, with appropriate progression to exclusive feeding and human milk use.
• Delayed provision of adequate energy (120 kcal/kg/day), respiratory distress syndrome, and sepsis were associated with increased weight loss and delayed weight regain.

Conclusions:

• Suboptimal parenteral nutrition practices in the NICU are linked to growth deficits in preterm infants.
• Optimizing nutritional support, including timely and adequate energy delivery, can mitigate growth retardation.
• Improving nutritional strategies in the NICU is crucial for reducing growth deficits in very low birth weight premature infants.