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Neonatal Nutrition in Low- and Middle-Income Countries: Promoting Growth and Development

Sarah Gregory1, Merhawit Abadi Hagos2, Jocelyne Bukeyeneza3,4,5

  • 1Division of Neonatology, Duke University, Durham, North Carolina.

Neoreviews
|February 28, 2026
PubMed

Insights

Optimizing preterm infant nutrition in low-resource settings requires tailored strategies. This includes using alternative fortifiers, optimizing intravenous fluids, and implementing non-feeding interventions for better neonatal growth.

Area of Science:

  • Neonatalogy
  • Pediatric Nutrition
  • Global Health

Background:

  • Preterm infants exhibit high metabolic demands and limited reserves, posing growth challenges.
  • Resource constraints in low- and middle-income countries (LMICs) exacerbate nutritional risks for preterm infants.
  • Effective neonatal intensive care unit (NICU) nutrition is crucial despite varying resource levels.

Purpose of the Study:

  • To explore neonatal growth and nutrition in LMICs.
  • To identify strategies for optimizing enteral and parenteral nutrition resources for preterm infants.
  • To provide guidance on managing nutritional challenges in resource-limited NICUs.

Main Methods:

  • Review of alternative fortifiers when infant formula is cost-prohibitive.
  • Strategies for optimizing intravenous fluids without total parenteral nutrition.
  • Exploration of non-feeding interventions to support growth.
  • Guidance on discharge feeding and growth assessment for extremely low-birth-weight infants.

Main Results:

  • Alternative fortifiers can be used when infant formula is unaffordable.
  • Intravenous fluid optimization is key in the absence of total parenteral nutrition.
  • Non-feeding interventions and tailored discharge plans improve growth outcomes.

Conclusions:

  • Tailored nutritional approaches are essential for preterm infants in LMICs.
  • Innovative resource management and interdisciplinary collaboration are critical.
  • Enhanced care for preterm infants globally relies on adaptive nutritional strategies.

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