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Enteral Nutrition in Preterm Neonates

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Textbook of Pediatric Gastroenterology, Hepatology and Nutrition

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Abstract

Preterm birth survivors are at a higher risk of faltering growth and developmental disabilities compared to their term counterparts. Appropriate nutrition is essential for the growth of preterm infants. Early administration of enteral nutrition (EN) in preterm newborns reduces the risk of adverse health outcomes and improves cognition in adulthood. Infants with birth body weight less than 1500 g develop a postnatal growth failure in the vast majority of the cases. During the early adaptive period of life (from birth to approximately day 7), hemodynamic instability associated with immaturity of the gastrointestinal tract limits the use of enteral nutrition. In this period, parenteral nutrition (PN) represents the main route of administration of nutrients. However, EN should be started as soon as possible as minimal enteral feeding (10–30 ml/kg/d) and progressively increased (by 20–30 ml/kg/d) until full enteral feeding is reached (120 kcal/kg/d). In the stable growing period, adequate nutritional requirements, including macronutrients and micronutrients, should be fully achieved by EN. Fortified human milk is considered the best source of nutrition for preterm babies. In routine clinical practice, supplementation of human milk (HM) with macro- and micronutrients is essential to meet nutritional requirements. Monitoring the growth velocity is crucial to assess the efficacy of EN. Counseling and a regular follow-up after discharge to ensure adequate growth are advisable.

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Authors and Affiliations

  1. Sapienza University of Rome, Policlinico Umberto I, Rome, Italy

    Gianluca Terrin, Maria Di Chiara, Giulia Sabatini & Mario De Curtis

  2. Department of Pediatrics, Neonatology Unit, Sapienza University of Rome, Rome, Italy

    Gianluca Terrin

  3. University of Liege, CHU de Liege, CHR de la Citadelle, Liege, Belgium

    Thibault Senterre

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  1. Section of Pediatric Gastroenterology Hepatology and Nutrition, University of Chicago, Chicago, IL, USA

    Stefano Guandalini

  2. Pediatric Liver, GI and Nutrition Center, Child Health, King’s College Hospital, London, UK

    Anil Dhawan

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Terrin, G., Di Chiara, M., Sabatini, G., Senterre, T., De Curtis, M. (2022). Enteral Nutrition in Preterm Neonates. In: Guandalini, S., Dhawan, A. (eds) Textbook of Pediatric Gastroenterology, Hepatology and Nutrition. Springer, Cham. https://doi.org/10.1007/978-3-030-80068-0_6

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