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Growth in relation to protein intake of low birth weight infants
Insights
Human milk adequately supports growth and development in very low birth weight infants. Higher protein formulas showed slightly increased early weight gain but no long-term benefits or neurodevelopmental differences.
Area of Science:
- Neonatal nutrition
- Pediatric growth and development
Background:
- Very low birth weight (VLBW) and preterm infants require specialized nutritional support.
- Optimizing protein intake is crucial for their growth and neurodevelopment.
Purpose of the Study:
- To assess the impact of varying postnatal protein intake on VLBW infant growth and development.
- To compare outcomes between infants fed human milk, standard formula, and higher protein formula.
Main Methods:
- Prospective longitudinal study of 48 VLBW infants (gestational age 30.8 weeks).
- Random allocation to three isocaloric diets: human milk (1.6 g/100 kcal), formula 1 (2.3 g/100 kcal), formula 2 (3.0 g/100 kcal) from 3rd to 7th week postnatal.
- Growth parameters, biochemical markers, and neurodevelopmental assessments up to 2 years of age were monitored.
Main Results:
- Formula-fed infants showed slightly higher weight gain during the study period (3-7 weeks).
- Higher B-urea-N and B-base deficit observed in formula-fed infants compared to human milk.
- No significant differences in growth (weight, length, head circumference) or neurodevelopmental outcomes up to 2 years of age across groups.
Conclusions:
- Human milk, preferably from the infant's own mother, is adequate for the early and long-term growth and development of VLBW infants.
- Higher protein formulas did not demonstrate superior long-term growth or neurodevelopmental advantages in this cohort.
Abstract:
In a prospective longitudinal study of 48 very low birth weight and preterm infants with mean birth weight 1385 +/- 343 g and gestational age 30.8 +/- 2.9 weeks 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 slight higher in the infants fed formula. There were no group differences in S-albumin but B-urea-N and B-base deficit were significantly higher in formula-fed infants compared to infants fed human milk. After the study period that lasted to about 20 weeks of age the slope in weight gain remained slightly higher for formula fed infants, whereas the gain in body length and hear 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. With few exceptions breastmilk-preferably from their own mothers-was adequate for both early and longterm growth and development of the very low birth weight infants in this population.