Expert recommendations for preterm neonates' growth goals: Considerations for clinicians

Area of Science:

• Neonatalogy
• Pediatric Nutrition
• Growth Monitoring

Background:

• Traditional recommendations for preterm infant growth approximate intrauterine rates.
• Preterm infant growth involves distinct phases: postnatal weight loss, parallel growth, and catch-up growth.
• Growth patterns are multifactorial, influenced by genetics, maternal health, infant morbidity, and nutrition.

Purpose of the Study:

• To re-evaluate traditional growth recommendations for preterm infants.
• To emphasize individualized growth expectations over arbitrary percentile goals.
• To address the terminology used to describe suboptimal infant growth.

Main Methods:

• Review of expert opinions and traditional recommendations on preterm infant growth.
• Analysis of growth patterns, including postnatal weight loss and catch-up growth.
• Discussion of factors influencing infant growth trajectories.

Main Results:

• Growth parallel to growth charts can be appropriate, even below specific percentiles.
• Individualized growth assessment is necessary, accounting for physiological and genetic variations.
• Expert groups discourage terms like "failure" or "restriction" for postnatal growth.

Conclusions:

• Universal growth goals (percentiles, z-scores) are inappropriate for preterm infants.
• Individualized growth monitoring is essential to identify modifiable factors and support optimal development.
• The term "faltering" is preferred over "failure" to describe growth deviations, reflecting potential for recovery.