Are the current feeding volumes adequate for the growth of very preterm neonates?

Area of Science:

• Neonatology
• Pediatric Nutrition
• Growth and Development

Background:

• Postnatal growth failure is common in very preterm neonates and linked to poor neurodevelopmental outcomes.
• Current feeding guidelines recommend 115–140 kcal/kg/day, not exceeding 200 ml/kg/day.
• Emerging evidence suggests higher feeding volumes may improve growth without complications.

Purpose of the Study:

• To explore optimal feeding practices for very preterm neonates to prevent postnatal growth failure.
• To evaluate the impact of different feeding volumes and nutrient supplies on infant growth.
• To address the ongoing discussion regarding nutritional strategies in neonatal intensive care.

Main Methods:

• Review of current guidelines and recommendations for neonatal nutrition.
• Analysis of randomized and observational studies investigating feeding volumes in preterm infants.
• Assessment of reported outcomes related to weight gain, growth, and complications.

Main Results:

• Higher feeding volumes, exceeding typical recommendations, have been associated with improved weight gain and growth in some studies.
• No significant complications were reported in studies utilizing higher feeding volumes.
• Data remains inconclusive regarding the definitive effect of high-volume feeds on overall growth and long-term outcomes.

Conclusions:

• Nutritional practices for very preterm and extremely preterm infants should be individualized.
• Further large-scale clinical trials are essential to establish optimal feeding practices and volumes.
• Preventing postnatal growth failure requires tailored nutritional support based on emerging evidence.