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Dietary composition and macronutrient storage in preterm infants.

B Reichman, P Chessex, G Verellen

    Pediatrics
    |September 1, 1983
    PubMed
    Summary

    Infants fed own mother's milk had lower metabolic rates and fat accretion but similar growth and protein accretion compared to formula-fed preterm infants. Nutrient intake significantly influenced growth and body composition.

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    Area of Science:

    • Neonatal Nutrition
    • Pediatric Gastroenterology
    • Metabolic Research

    Background:

    • Preterm infants of very low birth weight (VLBW) require optimized nutrition for growth and development.
    • The impact of feeding own mother's milk versus formula on nutrient metabolism in VLBW infants is not fully elucidated.
    • Understanding energy and macronutrient utilization is crucial for tailoring nutritional strategies in preterm neonates.

    Purpose of the Study:

    • To compare the influence of own mother's milk versus formula on energy and macronutrient oxidation and accretion in growing VLBW infants.
    • To assess the impact of different feeding strategies on metabolic rate and body composition changes.

    Main Methods:

    • Combined nutrient balance techniques and computerized indirect calorimetry were employed.

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  • Analysis included 22 studies of formula-fed infants and 15 studies of infants fed own mother's milk.
  • Measurements focused on energy, protein, and fat intake, oxidation, and accretion.

    • Main Results:

    • Infants fed own mother's milk exhibited a significantly lower metabolic rate (56.0 kcal/kg/d vs 62.6 kcal/kg/d).
    • Despite lower energy intake, own mother's milk-fed infants showed comparable growth rates in weight, length, and head circumference.
    • Own mother's milk group had lower fat intake, higher fat oxidation, and consequently lower fat accretion (16% of weight gain vs 33%). Protein accretion was similar between groups.

    Conclusions:

    • Own mother's milk feeding in VLBW infants is associated with lower metabolic rate and reduced fat accretion but supports comparable growth.
    • Protein intake, oxidation, and accretion were similar regardless of feeding type, suggesting efficient utilization.
    • Accretion rates of energy, fat, and protein are closely correlated with metabolizable intake, highlighting the importance of nutrient availability for growth composition.