An experimental infant formula developed to meet the specific nutritional needs of very-low-birth-weight infants was evaluated by 96-hour balance studies in ten preterm infants (birth weight: 1,130 to 1,530 gm). The formula contained 23.2 gm/liter of protein (whey protein/casein ratio, 60:40), 44.1 gm/liter of fat (50% medium-chain triglycerides) and 85.0 gm/liter of carbohydrate (50% lactose, 50% Polycose), and provided relatively higher amounts of calcium, phosphorus, vitamin D, and electrolytes than are in human milk. All infants were fed 150 ml/kg/day (120 calories/kg/day) by intermittent gavage. Balance studies were carried out nine days following establishment of oral intake. The mean (±SEM) nutrient retention rates revealed by balance studies in these infants (calcium, 170 ± 4 mg/kg/day; phosphorus, 78 ± 3 mg/kg/day; nitrogen, 426 ± 8 mg/kg/day; sodium, 1.4 ± 0.1 mEq/kg/day) were comparable to normal fetal accretion rates. The mean (±SEM) fat absorption was 92.5 ± 0.9%. No clinical intolerances or biochemical abnormalities were observed, and adequate postnatal growth was achieved in all infants. The diet proved to be nutritionally advantageous and safe for very-low-birth-weight infants.
We appreciate Dr. Pick's interest in our paper on dissimilar sized twins. It may be as Dr. Pick suggests that some infants of small birth weight for their gestational age grow and develop "normally." Our study has demonstrated the failure of the undersized member of twin pairs to achieve a comparable level of growth and development to that of the co-twin at the time of the study examination. The reasons for this continued disproportion in size are not clear. Further studies are necessary to relate all possible factors concerned in intrauterine growth retardation with the subsequent development of the child.
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