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Diet and infant behavior
A de Klerk1, K F Schulze, S Kashyap
1Department of Pediatrics, Columbia University College of Physicians and Surgeons, Babies and Children's Hospital (Presbyterian Hospital), New York, New York 10032, USA.
Insights
Preterm infants with rapid weight gain show distinct physiological and behavioral patterns compared to slow growers. These differences suggest altered autonomic nervous system balance in faster-growing preterm infants.
Area of Science:
- Neonatal Physiology
- Developmental Pediatrics
- Autonomic Nervous System Research
Background:
- Preterm infants exhibit variable growth rates despite standardized nutritional support.
- Understanding physiological differences between slow and rapid growers is crucial for optimizing care.
- Autonomic nervous system (ANS) function plays a key role in infant development and metabolic regulation.
Purpose of the Study:
- To investigate physiological and behavioral differences between preterm infants categorized as slow versus rapid growers.
- To explore potential correlations between growth rate and autonomic balance in preterm neonates.
- To identify specific markers that differentiate growth trajectories in preterm infants.
Main Methods:
- Prospective study of 142 preterm infants (mean gestation 31 weeks) with varied protein and energy intakes.
- Infants classified as slow or rapid growers based on weight gain velocity.
- Comparison of physiological parameters including heart rate, respiratory rate, energy expenditure, urinary C-peptide levels, and electroencephalogram (EEG) spectral edge frequency between groups.
Main Results:
- Rapid growers exhibited higher heart rates (166 vs. 160 bpm) and respiratory rates (55.7 vs. 53.9 bpm).
- Increased energy expenditure (64.8 vs. 61.6 kcal/kg/day), urinary C-peptide levels (1.59 vs. 0.79 ng/mL), and time in active sleep (78.0% vs. 75.2%) were observed in rapid growers.
- Rapid growers showed decreased spectral edge frequency in EEG (2.96 vs. 4.45 Hz) compared to slow growers.
Conclusions:
- Preterm infants with differing growth rates display significant physiological and behavioral variations.
- These observed patterns suggest that altered autonomic balance may underlie the differential growth observed in preterm infants.
- Further research into autonomic regulation is warranted to enhance nutritional strategies and developmental outcomes for preterm infants.
Abstract:
We studied 142 preterm infants (mean gestation 31 weeks, mean birthweight 1364 g) fed prospectively varied protein and energy intakes. Infants were grouped as either slow or rapid growers based on rate of weight gain. Rapid growers had increased heart rates (166 vs 160 beats/min), respiratory rates (55.7 vs 53.9 bpm), energy expenditure (64.8 vs 61.6 kcal kg(-1) day(-1)), urinary C-peptide levels (1.59 vs 0.79 ng ml(-1)) and time in active sleep (78.0 vs 75.2%), and decreased spectral edge frequency in the electroencephalogram (2.96 vs 4.45 Hz) compared to slow growers. We conclude that preterm infants growing at varying rates manifest physiological and behavioral differences, and that these patterns may reflect altered autonomic balance.