Nutrient-enriched formula versus standard term formula for preterm infants following hospital discharge (Review)

Hull York Medical School & Centre for Reviews and Dissemination, University of York, York, UK.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 03/2012; 3(3):CD004696. DOI: 10.1002/14651858.CD004696.pub4
Source: PubMed


Preterm infants are often much smaller than term infants by the time that they are discharged home from hospital. This review attempted to identify trial evidence about whether feeding these infants with formula enriched with nutrients rather than ordinary formula designed for term infants increased growth rates and improved development. We found 15 trials but these did not provide strong or consistent evidence that unrestricted feeding with nutrient-enriched formula affects growth and development up to about 18 months of age. Long-term growth and development has not yet been assessed.

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    • "Our findings are consistent with other studies [16-20] that investigated the effect of protein and energy supplementation after discharge on preterm infants’ neurodevelopment. However, it must be underlined that in all but one (ref. "
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    ABSTRACT: The availability and composition of preterm and post-discharge formulas (PDFs) have undergone considerable changes over the last decade. Human milk, supplemented with multi-component fortifier, is the preferred feed for very preterm infants as it has beneficial effects for both short- and long-term outcomes compared with formula. If supply of mother's milk or donor milk is inadequate, a breast milk substitute specifically designed for premature infants is the next option. Preterm formula is intended to provide nutrient intakes to match intrauterine growth and nutrient accretion rates and is enriched with energy, macronutrients, minerals, vitamins, and trace elements compared with term infant formulas. Post-natal longitudinal growth failure has been reported almost universally in extremely preterm infants. Since 2009, a nutritionally enriched PDF specifically designed for preterm infants post hospital discharge with faltering growth has been available in Australia and New Zealand. This formula is an intermediary between preterm and term formulas and contains more energy (73 kcal/100 mL), protein (1.9 g/100 mL), minerals, vitamins, and trace elements than term formulas. Although the use of a PDF is based on sound nutritional knowledge, the 2012 Cochrane Systematic Review of 10 trials comparing feeding preterm infants with PDF and term formula did not demonstrate any short- or long-term benefits. Health professionals need to make individual decisions on whether and how to use PDF.
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