Feeding of premature infant formula after hospital discharge of infants weighing less than 1800 grams at birth.
ABSTRACT A randomized, double-blind study was conducted to determine whether continued feeding of premature infant formula after hospital discharge improve biochemical measures of bone mineral or protein status and anthropometrics during the first 8 and 12 weeks, respectively, after initial hospital discharge. Forty-three subjects were randomized to receive either a 20 kcal/ounce standard cow's milk-based formula with iron or a 20 kcal/ounce premature infant formula with iron for 8 weeks after hospital discharge. Sixteen exclusively breast-fed infants (mother's own milk) who received a multivitamin supplement with iron were compared with infants in both formula groups. There were no differences among the three groups in gender, birth weight, gestational age, or weight and age at the time of study entry. Alkaline phosphatase values were lower in infants receiving premature infant formula than in those receiving standard formula 8 weeks after discharge. Phosphorus values were lower and alkaline phosphatase values higher in the human milk-fed group than in both formula groups 8 weeks after discharge despite supplementation with calcium, phosphorus, and vitamin D before and during the study. At 8 weeks after discharge, human milk-fed infants also had lower transferrin levels than infants fed formulas. Infants in both formula groups grew similarly in weight, whereas the infants fed human milk weighed less throughout the study. The group fed premature infant formula had greater mean length and head circumference than the standard formula or human milk-fed groups. These data indicate that premature infants weighing < 1800 gm at birth may benefit from the continuation of premature infant formula during the first 8 weeks after initial hospital discharge.
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ABSTRACT: Necrotizing enterocolitis (NEC) is the most common serious gastrointestinal disorder affecting very preterm or very low birth weight infants. The risk is inversely proportional to gestational age and weight at birth. Fetal growth restriction and compromise may be additional specific risk factors. Postnatally, a variety of practices have been implicated in the pathogenesis of NEC including formula milk feeding, early and rapid advancement of enteral feed volumes, and exposure to H2-receptor antagonists. NEC, particularly severe NEC requiring surgical intervention, is associated with acute morbidity and mortality, prolonged hospital stay, and adverse long-term neuro-developmental outcomes. With the exception of feeding with human milk, only limited evidence is currently available to support interventions to prevent NEC. Promising strategies that merit further evaluation in randomized controlled trials include the use of standardized feeding protocols and immuno-prophylaxis with prebiotics and probiotics.Paediatrics and Child Health 06/2011; 21(6):258-264. DOI:10.1016/j.paed.2010.12.002
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ABSTRACT: Recent nutritional research in very-low-birth-weight (VLBW) infants is focused on the prevention of protein malnutrition during the first postnatal weeks. At this early age, nutritional protein fortification depends on amino acid infusion via a central vein because of the immature gastrointestinal tract. In 2010 new guidelines on nutrition were proposed by the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition nutrition committee. In particular, the relative increase in the protein fraction in the nutrition of these infants aims to prevent early postnatal weight loss, to prevent morbidity, and to stimulate neurodevelopment. On the other hand, an increasing number of follow-up studies in VLBW infants indicate that, in particular, those infants who show rapid growth after preterm birth are at risk of metabolic consequences and cardiovascular disease later in life. In this review, we describe the quest to develop a customized diet that offers optimal nutrition at several time points of growth and development during the first year of life. This diet should prevent early malnutrition, enhance neurodevelopment, and limit the increase in total body fat during the first 6 mo. We question whether one type of early diet suffices for normal neurodevelopment with a normal body composition in later life or whether we need several types of diet at various stages of development.American Journal of Clinical Nutrition 06/2013; 98(2). DOI:10.3945/ajcn.112.045039 · 6.92 Impact Factor