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Energy intake and the nature of growth in low birth weight infants
Insights
Energy storage in low birth weight infants is crucial for growth and depends on energy intake. Optimized infant formulas, balancing energy, protein, and minerals, promote significant weight gain and accretion.
Area of Science:
- Neonatal nutrition
- Pediatric growth and development
- Infant metabolism
Background:
- Growth necessitates energy storage in developing tissues.
- Low birth weight infants have higher energy excretion and expenditure rates per body weight compared to adults.
- These rates increase with higher gross energy intake.
Purpose of the Study:
- To investigate energy storage and weight gain in growing low birth weight infants.
- To compare the composition of extrauterine weight gain with fetal growth.
- To evaluate the impact of different nutritional strategies on infant growth.
Main Methods:
- Energy-balance studies were conducted on growing low birth weight infants.
- Infants received either mother's milk or infant formula with gross energy intakes around 500 kJ X kg-1 X d-1.
- Studies also explored increased metabolizable energy intake and modified infant formulas.
Main Results:
- The energy storage cost of extrauterine weight gain in low birth weight infants is higher than that of a fetus of similar gestation.
- Increasing metabolizable energy intake alone beyond 500 kJ X kg-1 X d-1 did not proportionally increase weight gain rates.
- Low birth weight formulas with increased energy, protein, and minerals led to substantial weight gains and proportionate protein and fat accretion.
Conclusions:
- Nutritional composition, beyond just energy, is critical for optimizing growth in low birth weight infants.
- Tailored infant formulas are effective in promoting healthy weight gain and tissue accretion.
- Understanding energy metabolism is key to improving outcomes for premature infants.
Abstract:
Growth is accompanied by and depends on energy storage in growing tissue. The rate of energy storage in growing low birth weight infants depends on the rate of energy intake and on the rates of energy excretion and expenditure, both of which (on a body weight basis) are much higher than in adults, and both of which increase with increments of gross energy intake. Energy-balance studies of growing low birth weight infants on gross energy intakes approximating 500 kJ X kg-1 X d-1 of mothers' milk or of infant formula indicate that the composition of extrauterine weight gain of the low birth weight infant differs from that of the fetus of similar gestation, in that the energy storage cost of growth is much higher. Attempts to increase metabolizable energy intake beyond 500 kJ X kg-1 X d-1 by energy supplementation alone do not result in proportionately increased rates of weight gain; low birth weight formulae, in which energy, protein, and mineral contents are all increased can result in large weight gains with proportionate increases in rates of protein and fat accretion.