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Immunonutrition for Preterm Infants.

Verena Walsh1, William McGuire2

  • 1Centre for Reviews and Dissemination, University of York, York, United Kingdom.

Neonatology
|April 12, 2019
PubMed
Summary
This summary is machine-generated.

Optimizing nutrition for very preterm infants is crucial. Breast milk, prebiotics, and probiotics show promise in reducing necrotising enterocolitis (NEC) and infections, improving infant outcomes.

Keywords:
ImmunonutritionPreterm infants

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Area of Science:

  • Neonatal care
  • Infant nutrition
  • Gastroenterology

Background:

  • Very preterm infants face significant mortality and morbidity risks, including necrotising enterocolitis (NEC) and infections, often linked to prolonged hospitalisation and feeding strategies.
  • The immature infant gut's microbial and metabolic balance is influenced by enteral diet, particularly immunonutrients in breast milk, impacting NEC and neurodevelopmental outcomes.

Purpose of the Study:

  • To review current evidence on nutritional strategies for very preterm infants to reduce NEC, late-onset infection, and associated morbidities.
  • To evaluate the role of maternal breast milk, donor milk, immunonutrients, prebiotics, and probiotics in improving outcomes for extremely premature infants.

Main Methods:

  • Systematic review of existing literature and randomised controlled trials on infant nutrition and NEC prevention.
  • Analysis of the impact of various enteral feeding components and strategies on the gut microbiome and immune function in preterm neonates.

Main Results:

  • Human breast milk is supported as the primary nutrition source; pasteurised donor milk offers some NEC protection but has unclear nutritional adequacy and cost-effectiveness.
  • Supplementation with individual immunonutrients has not proven effective in preventing NEC or infection. Evidence for prebiotics and probiotics is stronger, but formulation concerns remain.
  • Strategies like avoiding gastric acid suppressants and implementing evidence-based feeding protocols are emerging as vital for reducing NEC, infection, and growth faltering.

Conclusions:

  • Optimising enteral nutrition, prioritising maternal breast milk, and judicious use of prebiotics/probiotics are key to improving outcomes for very preterm infants.
  • Further research is needed on the optimal use and safety of nutritional interventions, including donor milk and probiotics, for this vulnerable population.