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Metabolic consequences of high protein intake in premature infants appropriate for gestational age
Insights
High protein intake in premature infants can overwhelm their metabolism. Human milk is sufficient for preterm infants if adequate volumes are tolerated, avoiding unnecessary protein supplementation.
Area of Science:
- Neonatal Nutrition
- Infant Metabolism
- Pediatric Gastroenterology
Background:
- Premature infants require tailored nutrition for optimal growth and development.
- Assessing the metabolic impact of varying protein intake is crucial for preterm infant care.
- Human milk and specialized formulas offer different protein concentrations.
Purpose of the Study:
- To investigate the metabolic effects of different protein intakes in preterm infants.
- To determine the threshold for metabolic overloading due to excessive protein consumption.
- To evaluate the adequacy of human milk protein for preterm infants.
Main Methods:
- Studied infants appropriate for gestational age (1500-2000g) during their third week of life.
- Administered diets with varying protein levels: human milk and two formulas (1.7 and 2.1 g protein/100 ml).
- Monitored serum alpha-amino-nitrogen and urea, urinary nitrogen losses, stool output, and fat excretion.
Main Results:
- Increased protein intake correlated with higher serum alpha-amino-nitrogen and urea levels.
- Elevated urinary losses of total and alpha-amino-nitrogen were observed with higher protein intake.
- Greater stool volume, total nitrogen, and fat excretion occurred with increased protein consumption.
Conclusions:
- Protein intake exceeding 2.5 g/kg/24h leads to metabolic overload in preterm infants without apparent benefits.
- Human milk provides adequate protein for preterm infants when volumes of 180-200 ml/kg/24h are tolerated.
- Protein supplementation is only warranted for preterm infants unable to tolerate sufficient feeding volumes from human milk or standard formulas.
Abstract:
The metabolic consequences of different levels of protein intake were studied in premature infants appropriate for gestational age (birth weight between 1500 and 2000 g) during the third week of life. The different protein intake was the result of different nutrition, human milk and two formulae containing 1.7 and 2.1 g protein/100 ml, respectively. The increasing protein intake causes an increase in the alpha-amino-nitrogen as well as the urea concentration in the serum, an elevation of total and alpha-amino-nitrogen losses in urine, increased amounts of stool accompanied by increased total nitrogen as well as fat excretion. The results indicate that a protein intake of more than 2.5 g/kg X 24 h creates a metabolic overloading without any advantages. Thus, human milk of mothers delivering preterm is a sufficient nutrition for these infants, also with regard to protein requirements, if feeding volumes of 180 to 200 ml/kg X 24 h are tolerated. Supplementation of human milk or nutrition with high protein formulae can be justified only in infants who cannot tolerate sufficient feeding volumes.