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Feeding the preterm infant

  • Practical Pediatric Nephrology
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Abstract

The sick preterm infant has special nutritional needs, and the provision of appropriate nutrition is now recognised as an important part of the increasingly intensive management of this population. “Optimal” nutrition is difficult to define for an individual infant, but prospective randomised studies have shown that the early diet given to preterm infants can have a major impact on their neurological development and growth, with the best outcomes for those receiving either a preterm formula or maternal milk fortified with a range of nutrients. In contrast, diets suitable for term infants do not meet the needs of small preterm infants, either in the short or longer term, and should not be used. This article reviews the nutritional needs of the preterm infant and outlines the strategies commonly used in this area of neonatal intensive care.

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References

  1. Pediatrics CoNAAo (1981) Use of intravenous fat emulsions in pediatric patients. Pediatrics 68: 738–743

    Google Scholar 

  2. Zlotkin SH, Bryan MH, Anderson GH (1981) Intravenous nitrogen and energy intakes required to duplicate in utero nitrogen accretion in prematurely born human infants. J Pediatr 99: 115–120

    Google Scholar 

  3. Greene HL, Hambidge KM, Schanler R, Tsang RC (1988) Guidelines for the use of vitamins, trace elements, calcium, magnesium, and phosphorus in infants and children receiving total parenteral nutrition: report of the subcommittee on pediatric parenteral nutrient requirements from the committe on clinical practice issues of the American Society for Clinical Nutrition. Am J Clin Nutr 48: 1324–1342

    Google Scholar 

  4. Lucas A, Baker BA, Morley R (1993) Hyperphenylalaninaemia and outcome in intravenously fed preterm infants. Arch Dis Child 68: 579–583

    Google Scholar 

  5. Brans YW, Andrew DS, Carrillo DW, Dutton EP, Menchaca EM, Puleo-Scheppke BA (1988) Tolerance of intravenous fat emulsions in very-low-birth-weight neonates. Am J Dis Child 142: 145–152

    Google Scholar 

  6. Fielding CJ (1970) Human lipoprotein lipase inhibition of activity by cholesterol. Biolchim Biophys Acta 218: 221–226

    Google Scholar 

  7. Hammerman C, Aramburo MJ (1988) Decreased lipid intake reduces morbidity in sick premature infants. J Pediatr 113: 1083–1088

    Google Scholar 

  8. Cooke RWI (1991) Factors associated with chronic lung disease in preterm infants. Arch Dis Child 66: 776–779

    Google Scholar 

  9. Hanning RM, Atkinson SA, Whyte RK (1991) Efficacy of calcium glycerophosphate vs. conventional mineral salts for total parenteral nutrition in low-birth weight infants: a randomised clinical trial. Am J Clin Nutr 54: 903–908

    Google Scholar 

  10. Bishop NJ, Robinson MJ, Jamieson R, Day JP, Hewitt CD, O'Hara M (1989) Increased concentration of aluminium in the brain of a parenterally fed preterm infant. Arch Dis Child 64: 1316–1317

    Google Scholar 

  11. Sedman AB, Klein GL, Merrit RJ, Miller NL, Weber KO, Gill WL, Anand H, Alfrey AC (1985) Evidence of aluminium loading in infants receiving intravenous therapy. N Engl J Med 312: 1337–1343

    Google Scholar 

  12. Lucas A, Morley R, Cole TJ, Gore SM, Lucas PJ, Crowle P, Pearse R, Boon AJ, Powell R (1990) Early diet in preterm babies and developmental status at 18 months. Lancet 335: 1477–1481

    Google Scholar 

  13. Lucas A, Brooke OG, Baker BA, Bishop N, Morley R (1989) High alkaline phosphatase activity and growth in preterm neonates. Arch Dis Child 64: 902–909

    Google Scholar 

  14. Lucas A, Gore SM, Cole TJ, Bamford MF, Dosseter JFB, Barr I, Dicarlo L, Cork S, Lucas PJ (1984) A multicentre trial on the feeding of low birthweight babies: effects of diet on early growth. Arch Dis Child 59: 722–730

    Google Scholar 

  15. Gordon HH, Levine SZ, McNamar H (1945) Feeding of premature infants. A comparison of human and cow's milk. Am J Dis Child 73: 442–452

    Google Scholar 

  16. Gross SJ (1983) Growth and biochemical response of preterm infants fed human milk or modified infant formula. N Engl J Med 308: 237–241

    Google Scholar 

  17. Lucas A, Cole TJ (1990) Breast milk and neonatal necrotising enterocolitis. Lancet 336: 1519–1523

    Google Scholar 

  18. Lucas A (1987) AIDs and milk bank closures. Lancet I: 1092–1093

    Google Scholar 

  19. Lucas A, Morley R, Cole TJ, Gore SM, Davis JA, Bamford MFM, Dossetor JFB (1989) Early diet in preterm babies and developmental status in infancy. Arch Dis Child 64: 1570–1578

    Google Scholar 

  20. Morley R, Cole PJ, Powell R, Lucas PJ (1988) Mother's choice to provide breast milk and developmental outcome. Arch Dis Child 63: 1382–1385

    Google Scholar 

  21. Lucas A, Morley RM, Cole TJ, Lister G, Leeson-Payne C (1992) Breast milk and subsequent intelligent quotient in children born preterm. Lancet 339: 261–264

    Google Scholar 

  22. Herbst JJ (1983) Development of suck and swallow. J Pediatr Gastroenterol Nutr 2: S131-S135

    Google Scholar 

  23. Steer P, Lucas A, Sinclair JC (1992) Feeding the low birthweight infant. In: Sinclair JC, Bracken MB (es) Effective care of the newborn infant, vol I. Oxford University Press, New York, pp 94–160

    Google Scholar 

  24. Dunn L, Hulman S, Weiner J, Kliegman R (1988) Beneficial effects of early hypocaloric enteral feeding on neonatal gastrointestinal function: preliminary report of a randomised trial. J Pediatr 112: 622–629

    Google Scholar 

  25. Levine GM, Deren JJ, Steiger E, Zinno R (1974) Role of oral intake in maintenance of gut mass and disaccharidase activity. Gastroenterology 67: 975–982

    Google Scholar 

  26. Slagle TA, Gross SJ (1988) Effect of early enteral substrate on subsequent feeding tolerance. J Pediatr 113: 526–531

    Google Scholar 

  27. Lucas A, Bloom SR, Aynsley-Green A (1983) Metabolic and endocrine effects of depriving preterm infants of enteral nutrition. Acta Paediatr Scand 72: 245–249

    Google Scholar 

  28. Schreiner RL, Lemons JAS, Gresham EL (1979) A new complication of nutritional management of the low-birthweight infants. Pediatrics 63: 683–685

    Google Scholar 

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Bishop, N.J. Feeding the preterm infant. Pediatr Nephrol 8, 494–498 (1994). https://doi.org/10.1007/BF00856548

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  • DOI: https://doi.org/10.1007/BF00856548

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