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Feeding preterm infants after hospital discharge: effect of dietary manipulation on nutrient intake and growth
R J Cooke1, I J Griffin, K McCormick
1Special Care Baby Unit, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.
Insights
Preterm infants fed preterm formula after hospital discharge showed faster growth. Boys fed preterm formula grew faster than girls on preterm formula or boys on term formula.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Growth and Development
Background:
- Preterm infants require specialized nutrition after hospital discharge.
- The choice of infant formula (preterm vs. term) may impact growth and nutrient intake.
- Understanding optimal feeding strategies is crucial for preterm infant development.
Purpose of the Study:
- To compare formula intake, weaning, and growth in preterm infants fed standard term or preterm formula post-discharge.
- To evaluate the effects of different formula types on infant growth parameters up to 6 months corrected age.
Main Methods:
- Randomized controlled trial comparing three feeding groups (preterm formula, term formula, or a combination).
- Biweekly and monthly assessments of infant intake, anthropometry, and blood sampling.
- Statistical analysis using ANOVA to compare outcomes between groups.
Main Results:
- Infant boys showed faster growth than girls on preterm formula or boys on term formula.
- Volume of intake varied between groups, but energy intake remained similar.
- Differences in formula composition led to varied protein, calcium, and phosphorus intake, correlating with blood urea nitrogen levels.
Conclusions:
- Preterm infants can adjust intake volume to compensate for energy density differences in formulas.
- Feeding preterm formula post-discharge supports faster growth in infant boys compared to term formula or girls on preterm formula.
- Formula composition significantly influences nutrient intake and related biochemical markers in preterm infants.
Abstract:
The objective of this study was to compare formula intake, the time of weaning, and growth in preterm infants (< or = 1750-g birth weight, < or = 34-wk gestation) fed a standard term or preterm infant formula after initial hospital discharge. Infants were randomized at hospital discharge to be fed a preterm infant formula from discharge to 6 mo corrected age (group A), a term formula from discharge to 6 mo (group B), or the preterm formula (discharge to term) and the term formula (term to 6 mo (group C). Infants were seen biweekly (discharge to term) and monthly (term to 6 mo), when intake was measured and anthropometry and blood sampling were performed. The results were analyzed using ANOVA. Although nutrient intake was similar, at 6 mo girls were lighter (6829 versus 7280 g) and shorter (64.4 versus 66.0 cm) than boys (p < 0.05). Patient characteristics were similar between the treatment groups. Although the volume of intake differed (B > C > A; p < 0.001), energy intake was similar in the groups. Because of differences in formula composition, protein, calcium, and phosphorus intakes differed (B < C < A; p < 0.001). Lower protein intakes were related to lower blood urea nitrogen levels (B < C < A; p < 0.001). At 6 mo, infant boys in B and C were lighter (6933, 6660 < 7949 g), shorter (65.3, 64.9 < 67.1 cm), and had a smaller head circumference (43.7, 43.7 < 44.8 cm; p < 0.05) than infants in group A. Preterm infants were found to increase their volume of intake to compensate for differences in energy density between formulas. After hospital discharge, infant boys fed a preterm formula grew faster than infant girls fed a preterm formula or infant boys fed a term formula.