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Medium-chain triglyceride supplementation in preterm infants: A prospective cohort study

Mônika Louise Chaves Costa1, Amanda Caroline Pereira Nunes2, Raísa Acácio França Costa1

  • 1Dietitian, Postgraduate Program in Applied Sciences to Women's Health, Januário Cicco Maternity Teaching Hospital, Federal University of Rio Grande do Norte, Natal, RN, Brazil.

Clinical Nutrition ESPEN
|May 12, 2026
PubMed

Insights

Medium-chain triglyceride (MCT) supplementation was more common in preterm infants with greater clinical complexity. These infants experienced poorer weight gain and longer hospital stays, suggesting MCT may not improve outcomes in this population.

Area of Science:

  • Neonatal Nutrition
  • Pediatric Gastroenterology
  • Clinical Pediatrics

Background:

  • Optimizing postnatal growth in preterm infants is a significant challenge in neonatal intensive care.
  • Medium-chain triglycerides (MCTs) offer rapid energy availability, but their use and impact on growth in preterm infants require further investigation.
  • Limited prospective data exist on MCT supplementation in routine neonatal care and its association with clinical complexity.

Purpose of the Study:

  • To investigate the utilization of MCT supplementation in preterm infants.
  • To explore the relationship between MCT supplementation and indicators of clinical complexity in this population.
  • To assess the impact of MCT supplementation on growth and clinical outcomes in preterm infants.

Main Methods:

  • A prospective cohort study included preterm infants (<37 weeks gestation, <2.500 g birth weight) admitted to a neonatal intensive care unit (NICU).
  • Infants were stratified based on MCT supplementation status.
  • Associations between birth characteristics, clinical outcomes, anthropometric parameters, and NICU length of stay were analyzed concerning MCT use.

Main Results:

  • MCT supplementation was more frequent in infants with greater prematurity, low birth weight, bronchopulmonary dysplasia (BPD), and extrauterine growth restriction (EUGR).
  • Among infants receiving MCT, only 9% achieved adequate weight at discharge.
  • MCT supplementation was associated with the greatest drop in weight Z-score and longer hospital stays.

Conclusions:

  • MCT supplementation was disproportionately administered to preterm infants with higher clinical severity.
  • Findings suggest MCT supplementation may not be associated with improved growth or shorter hospital stays in complex preterm infants.
  • Further robust studies are necessary to elucidate the precise role of MCT supplementation in neonatal nutrition and growth optimization.
Abstract

Keywords:
Dietary supplementNeonatal intensive care unitPreterm infant

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