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Reevaluation of Protein Intake for Preterm Infants

Masahiko Kawai1

  • 1Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

American Journal of Perinatology
|April 25, 2018
PubMed

Insights

Aggressive nutrition for preterm infants may not improve outcomes and could increase risks for later health problems. Optimal protein intake needs reevaluation based on infant metabolism.

Area of Science:

  • Neonatal nutrition
  • Pediatric endocrinology
  • Developmental pediatrics

Background:

  • Undernutrition in extremely preterm infants is linked to psychomotor delay.
  • An "aggressive nutritional approach" is commonly used, focusing on early catch-up growth.
  • Current evidence lacks definitive proof of benefits from aggressive nutrition for mortality, growth, or neurodevelopment.

Purpose of the Study:

  • To survey current opinions on preterm infant nutrition.
  • To propose a new concept for optimized protein intake in preterm infants.
  • To consider the differences in amino acid metabolism between fetuses and preterm infants.

Main Methods:

  • Review of current scientific literature and opinions on preterm infant nutrition.
  • Analysis of epidemiological data linking early nutrition to long-term health.
  • Proposal of a novel concept for protein administration based on metabolic differences.

Main Results:

  • The benefits of aggressive nutrition for preterm infants remain unproven.
  • Epidemiological studies suggest potential risks of rapid catch-up growth and high protein intake.
  • These risks include later-life insulin resistance, diabetes, and cardiovascular issues.

Conclusions:

  • The optimal nutritional strategy, particularly protein administration, for preterm infants requires reevaluation.
  • A new concept focusing on optimized protein amounts, considering fetal vs. preterm infant amino acid metabolism, is proposed.
  • Further research is needed to establish evidence-based guidelines for preterm infant nutrition.

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