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"Aggressive" Feeding of Very Preterm Neonates and Body Mass Index at School Age
Antonios Gounaris1, Rozeta Sokou2, Martha Theodoraki2
1Neonatal Clinic-NICU, University General Hospital, 41222 Larissa, Greece.
Insights
Aggressive neonatal feeding for very preterm neonates (VPN) did not impact body mass index (BMI) at ages 2 and 8. The type and quantity of milk also showed no effect on later school-age BMI.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Metabolic Health
Background:
- The long-term metabolic health consequences of aggressive feeding strategies for very preterm neonates (VPN) are not well understood.
- Investigating the link between early nutrition and later body mass index (BMI) is crucial for optimizing infant care.
Purpose of the Study:
- To assess the impact of "aggressive" neonatal nutrition policies on the BMI of very preterm neonates (VPN) at ages 2 and 8 years.
- To determine if feeding strategies influence long-term growth and obesity risk in this vulnerable population.
Main Methods:
- A cohort study comparing 84 VPN receiving "aggressive" nutrition (Group A) with 62 term neonates (Group B).
- Group A was stratified by milk type (fortified breast milk/preterm formula vs. exclusive preterm formula) and quantity (180-210 mL/kg/day vs. 210-260 mL/kg/day).
- Body mass index (BMI) was measured at 2 and 8 years and analyzed using centile charts.
Main Results:
- No significant differences in BMI or BMI centile distribution were observed between the VPN group and controls at ages 2 and 8.
- Subgroup analyses revealed no significant impact of milk type or quantity on BMI at either follow-up point.
- Early "aggressive" feeding did not lead to altered BMI trajectories in very preterm infants by school age.
Conclusions:
- "Aggressive" and individualized feeding policies for very preterm neonates (VPN) did not affect BMI or obesity rates at ages 2 and 8.
- The type and quantity of milk feeds during hospitalization had no discernible impact on school-age BMI.
- Larger, prospective studies are warranted to confirm these findings and explore other long-term outcomes.
Introduction:
The effects of "aggressive" neonatal feeding policies of very preterm neonates (VPN) and the risk of metabolic syndrome later in life remain questionable. We aimed to evaluate the effect of our "aggressive" nutrition policies of VPN during hospitalisation on body mass index (BMI) at ages 2 and 8 years.
Materials And Methods:
Eighty four VPN, who received "aggressive" nutrition during hospitalisation in an effort to minimise postnatal growth restriction (PGR) (group A), and 62 term neonates, as controls (group B), were enrolled in the study. Group A was further divided in four subgroups depending on the type (A1: fortified expressed breast milk and preterm formula; A2: exclusively preterm formula) and quantity of milk received (A3: maximum feeds 180-210 mL/kg/day; A4: maximum feeds 210 and up to 260 mL/kg/day). BMI was calculated at ages 2 and 8 years and plotted on the centile charts.
Results:
There was no significant difference in BMI between groups A and B at 2 and 8 years, respectively, in both absolute BMI values and their centile chart distribution. There was no significant difference in BMI at 2 and 8 years either between subgroups A1 and A2 or between subgroups A3 and A4.
Conclusions:
"Aggressive" and individualised feeding policy for VPN did not affect the BMI and obesity rates at ages of 2 and 8 years in our study population. The type and quantity of milk feeds had no impact on their BMI at school age. Further larger studies are needed to confirm our results.
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