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Feeding, growth, and biochemical studies in very low birthweight infants
Insights
Early weaning in preterm infants (28-32 weeks gestation) did not negatively impact their growth or metabolic health. Catch-up growth was achieved by one year, regardless of weaning timing, supporting flexible infant feeding practices.
Area of Science:
- Neonatal Nutrition
- Pediatric Growth and Development
- Preterm Infant Care
Background:
- Premature infants (gestational age 28-32 weeks) often experience growth faltering.
- Optimal timing for introducing solid foods (weaning) in these vulnerable infants remains a key concern for clinicians and parents.
- Understanding the impact of early versus later weaning on growth and metabolic status is crucial for evidence-based infant feeding guidelines.
Purpose of the Study:
- To investigate the effects of early weaning (within 4 months post-expected delivery date) versus later weaning on catch-up growth and metabolic markers in preterm infants.
- To assess whether early introduction of solids influences energy and protein intake or causes metabolic stress in this population.
- To determine if weaning timing affects the achievement of growth milestones by 12 months of corrected age.
Main Methods:
- Longitudinal study of 50 preterm infants (gestational age 28-32 weeks, birthweight <1501g).
- Assessment of formula and weaning food intake, energy and protein intake, and serum biochemical indices (sodium, potassium, urea, protein, osmolality) at expected delivery date and 4 months corrected age.
- Comparison of infants weaned early (within 4 months) versus those weaned later.
Main Results:
- Infants weaned within 4 months showed similar energy/protein intakes and biochemical profiles compared to those weaned later.
- Both early and later weaned groups achieved catch-up growth, moving from below the 3rd centile at expected delivery date to the 10-25th centile by 1 year corrected age.
- No significant differences in metabolic stress markers were observed between the early and later weaning groups.
Conclusions:
- Early weaning in preterm infants (28-32 weeks gestation) is not associated with adverse metabolic outcomes or impaired catch-up growth.
- Preterm infants can achieve significant catch-up growth by 1 year of age, irrespective of the timing of weaning within the first 4 months post-expected delivery.
- These findings support a more flexible approach to introducing solid foods in preterm infants, focusing on individual infant cues and parental support.
Abstract:
Fifty infants of gestational age 28 to 32 weeks and birthweight less than 1501 g were reviewed on the expected date of delivery and at conceptional ages of 4, 8, and 12 months. All infants were at home by the expected delivery date, were fed on demand, and weighed regularly. On the expected delivery date and at 4 months, the amounts of formula milk and weaning food accepted were recorded; energy and protein intakes were calculated; and serum sodium, potassium, urea, protein, and osmolality were measured. The birthweight of these infants ranged between the 3rd and 75th centiles (on average about the 20th) but at the expected delivery date was, on average, below the 3rd centile. Infants who had been weaned in the first 4 months after the expected delivery date (n = 26) had similar energy and protein intakes and similar biochemical indices to those weaned later (n = 24). They achieved catch up growth (below 3rd to 10-25th centile) by 1 year, irrespective of the time of weaning and without any differences in metabolic 'stress'.