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A comparative study of varying protein intake in low birthweight infant feeding
Insights
Higher protein formulas for preterm infants showed slightly increased weight gain but no long-term growth or neurodevelopmental differences compared to human milk. Biochemical markers indicated potential metabolic stress with higher protein intakes.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Developmental Pediatrics
Background:
- Optimal protein intake is crucial for very low birthweight (VLBW) and preterm infants' growth and development.
- Existing research suggests varying protein levels may impact short-term growth and metabolic markers.
Purpose of the Study:
- To assess the impact of different postnatal protein intakes on VLBW and preterm infants.
- To compare growth parameters, biochemical markers, and neurodevelopmental outcomes across varying protein diets.
Main Methods:
- Prospective longitudinal study of 48 VLBW/preterm infants (birthweight 1385±343g, gestational age 30.8±2.9 weeks).
- Random allocation to three isocaloric diets: human milk (1.6g/100kcal), formula 1 (2.3g/100kcal), and formula 2 (3.0g/100kcal) from 3rd to 7th week of life.
- Monitoring of weight gain, length, head circumference, serum albumin, blood urea nitrogen (BUN), base deficit, and neurodevelopmental outcomes up to 2 years.
Main Results:
- Formula groups (2.3 and 3.0g/100kcal) showed slightly higher mean weight gain during the study period.
- Infants fed higher protein formulas had significantly increased blood urea nitrogen and base deficit compared to human milk.
- No significant differences in serum albumin, body length, head circumference, or neurodevelopmental outcomes were observed up to 2 years of age.
Conclusions:
- While higher protein formulas may promote slightly faster initial weight gain in preterm infants, they are associated with altered biochemical markers.
- Long-term growth and neurodevelopmental outcomes appear unaffected by protein intake variations within the studied range.
- Human milk remains a benchmark, and careful consideration of protein levels and their metabolic impact is warranted for preterm infant nutrition.
Abstract:
In a prospective longitudinal study of 48 very low birthweight and preterm infants with mean birthweight 1 385 +/- 343 and gestational age 30.8 +/- 2.9 w an assessment was made of the impact of varying the protein intake in the postnatal period from the 3rd to 7th week of life. The infants were randomly allocated to one of three dietary groups with isocaloric energy supply but different protein content--i.e. human milk (1.6 g/100 kcal), formula 1 (2.3 g/100 kcal) and formula 2 (3.0 g/100 kcal). In the human milk group 12 of 18 infants were fed their own mother's breastmilk. During the study period the mean weight gain was slightly higher in the infants fed formula 1 and 2. There were no group differences in S-albumin whereas B-urea-N and B-base deficit were significantly increased in the formula fed infants in comparison to infants fed human milk. After the study period until around 15 weeks of age the slope in weight gain remained slightly higher for formula fed infants. However, the gain in body length and head circumference was equal in all three groups. After around 8 months of age there was no difference in any growth parameter. Neurodevelopmental examinations showed no group differences during the follow-up period to 2 years of age.