Enteral Nutrient Supply for Preterm Infants: Commentary From the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition

Abstract

The number of surviving children born prematurely has increased substantially during the last 2 decades. The major goal of enteral nutrient supply to these infants is to achieve growth similar to foetal growth coupled with satisfactory functional development. The accumulation of knowledge since the previous guideline on nutrition of preterm infants from the Committee on Nutrition of the European Society of Paediatric Gastroenterology and Nutrition in 1987 has made a new guideline necessary. Thus, an ad hoc expert panel was convened by the Committee on Nutrition of the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition in 2007 to make appropriate recommendations. The present guideline, of which the major recommendations are summarised here (for the full report, see http://links.lww.com/A1480), is consistent with, but not identical to, recent guidelines from the Life Sciences Research Office of the American Society for Nutritional Sciences published in 2002 and recommendations from the handbook Nutrition of the Preterm Infant. Scientific Basis and Practical Guidelines, 2nd ed, edited by Tsang et al, and published in 2005. The preferred food for premature infants is fortified human milk from the infant's own mother, or, alternatively, formula designed for premature infants. This guideline aims to provide proposed advisable ranges for nutrient intakes for stable-growing preterm infants up to a weight of approximately 1800 g, because most data are available for these infants. These recommendations are based on a considered review of available scientific reports on the subject, and on expert consensus for which the available scientific data are considered inadequate.

Preterm human milk composition: a systematic literature review

“…The optimal nutrition for preterm infants is to be fed human breast milk (4,5) , and to mirror the growth and development of the age-matched healthy fetus. However, the nutrient and energy contents of native breast milk are insufficient to meet the needs of the preterm infant (5)(6)(7) , and fortification processes are thus used to assist in achieving the latest European recommended intakes (8) . These recommendations target 460-565 kJ/kg per d (110-135 kcal/kg per d), with 4·0-4·5 g protein/kg per d (3·6-4·1 g protein/418·4 kJ (100 kcal)) for preterm infants weighing <1000 g and 3·5-4·0 g protein/kg per d (3·2-3·6 g protein/418·4 kJ (100 kcal)) for infants weighing between 1000 and 1800 g (8) .…”

Promoting healthy growth and nutrition in preterm infants: A challenge for clinicians and researchers

“…The accepted reference daily intake of protein, which determines the rate of accretion of lean mass (longitudinal growth), is 3.5-4.5 g/kg/day. The dietary reference intake for daily calorie is 135-145 kcal/kg/day [6].…”

Neonatal high protein intake enhances neonatal growth without significant adverse renal effects in spontaneous IUGR piglets

“…2010). Early postnatal growth restriction affects morbidity and long‐term neurocognitive functions (Ehrenkranz et al.…”