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Feeding and Nutrition

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Emerging Topics and Controversies in Neonatology

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Abstract

Nutritional care holds the key to optimising outcomes for preterm infants and is relevant to every healthcare practitioner on the neonatal unit. Without adequate nutrient intakes, time coordinated brain development and growth cannot be promoted, recovery from acute neonatal morbidities will be impaired, and long term organ, muscle and brain growth will be permanently affected. Recent studies have clarified the role of nutrient intakes in the first few days and have contributed to the evidence base for updated European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) parenteral nutrition consensus guidelines. However, controversy surrounding optimal amino acid intakes and the approach to energy intakes and hyperglycaemia persists. The incidence of necrotising enterocolitis (NEC) is increasing as early respiratory deaths decrease, but randomised controlled trials exploring the timing of initiation and speed of increase of milk feeds show little impact on the incidence of NEC and sepsis. Accumulating data continue to show a dose response benefit from the use of mother’s own milk in reducing NEC, sepsis and other common morbidities, however the benefits of donor human milk and probiotics remain hotly debated and clinical practice continues to vary widely. Further large scale randomised controlled trials will be needed to further improve care.

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  1. Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

    Nicholas D. Embleton

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  1. Department of Health Sciences, George Davies Centre for Medicine, University of Leicester, Leicester, UK

    Elaine M. Boyle

  2. Department of Health Sciences, George Davies Centre for Medicine, University of Leicester, Leicester, UK

    Jonathan Cusack

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Embleton, N.D. (2020). Feeding and Nutrition. In: Boyle, E., Cusack, J. (eds) Emerging Topics and Controversies in Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-030-28829-7_16

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