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Updated: Nov 23, 2025

Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Assessment of early nutritional intake in preterm infants with bronchopulmonary dysplasia: a cohort study
Brunna G Milanesi1, Paola At Lima1, Letícia D Villela1
1Neonatology, Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Av. Rui Barbosa, 760, Flamengo, RJ, CEP 22250-020, Rio de Janeiro, Brazil.
Insights
Very preterm newborns who developed bronchopulmonary dysplasia (BPD) received inadequate calorie/protein ratios in early life. Nutritional support remains a critical challenge for these vulnerable infants.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Respiratory Medicine
Background:
- Optimal nutrition is crucial for very preterm infants.
- Early nutritional support can mitigate severe bronchopulmonary dysplasia (BPD).
- Nutritional deficits in early life are linked to adverse outcomes in preterm neonates.
Purpose of the Study:
- To evaluate nutritional intake and the calorie/protein ratio in the first four weeks of life for very preterm newborns.
- To identify associations between nutritional supply and the development of bronchopulmonary dysplasia (BPD).
Main Methods:
- Cohort study of 78 very preterm newborns.
- Collected data on anthropometrics, weekly weight, and feeding practices.
- Analyzed nutritional intake, including calorie and protein rates and the calorie/protein ratio.
Main Results:
- Newborns who developed BPD had lower gestational age, birth weight, and term-age Z-scores.
- Infants with BPD experienced delayed enteral feeding and longer parenteral nutrition.
- Newborns with BPD received lower calorie and fluid rates after week two and a suboptimal calorie/protein ratio through week four.
Conclusions:
- A calorie/protein ratio below recommended levels was observed in preterm infants who developed BPD.
- Nutritional provision for preterm newborns, particularly those at risk for BPD, presents ongoing challenges.
- Inadequate early nutrition may contribute to BPD development in very preterm infants.
Abstract:
This cohort study evaluated the nutritional supply in 78 very preterm newborns, with 20.5% developing bronchopulmonary dysplasia (BPD). This work aimed to evaluate the nutritional intake and the calorie/protein ratio received in the first 4 weeks of life. Anthropometric measures at birth and term age, the weight at each of the first 4 weeks of life, and the feeding practices were registered. The mean gestational age and birth weight were lower in those who developed BPD. At term age, head circumference and length Z-scores were significantly lower in newborns with BPD, who started enteral feeding and reached full diet later, staying longer in parenteral nutrition. The protein rate received by all newborns was similar, whether developing BPD or not, but those who developed BPD received significantly lower fluid volume and calorie rates after the second week. The daily calorie/protein ratio (30 kcal/1-g protein) was reached by 88.7% of the newborns who did not develop BPD in the third week, with those who developed BPD receiving less than this ratio until the second week, persisting in 56.3% of them on the fourth week.Conclusion: A calorie/protein ratio below that recommended for growth was found in preterm newborns who developed BPD, and providing nutrition for these newborns remains a challenge. What is Known: • The importance of preterm newborn nutrition is well known. • Early nutritional support may avoid severe BPD. What is New: • Newborns who developed BPD received a calorie/protein ratio below that recommended for preterm newborns' growth during the first 2 weeks of life, lasting until the fourth week in most of these newborns.
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