Intersite Differences in Weight Growth Velocity of Extremely Premature Infants

Olsen, Irene E.; Richardson, Douglas K.; Schmid, Christopher H.; Ausman, Lynne M.; Dwyer, Johanna T.

doi:10.1542/peds.110.6.1125

Cited by 150 publications

(112 citation statements)

References 31 publications

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“…Furthermore, our observation that the protein intake of 3.5 g kg À1 per day in our P/E group, which was associated with improved postnatal growth, is consistent with the published literature. [14][15][16]25,26 Our study was limited by the small number of infants enrolled, but, as significant differences in growth are seen despite the limited number of infants, we believe that this observation is clinically significant. Nevertheless, it is possible with a larger sample size that growth rates would not have differed between groups or that days on steroids would be significantly different between groups.…”

Section: Discussionmentioning

confidence: 94%

“…18 Our findings of the importance of the type of calories supplied for in-hospital preterm growth have been emphasized by other investigators. [14][15][16][24][25][26][27][28][29][30] In 1998, Carlson and Zeigler 24 published a longitudinal study of 51 preterm infants and their protein intake, energy intake and subsequent growth. Regression analysis suggested that protein intake related positively to growth.…”

Section: Discussionmentioning

confidence: 99%

“…Regression analysis suggested that protein intake related positively to growth. Olsen et al 25 showed an association between increased protein intake and improved growth velocity in regression analysis of a cohort consisting infants from six neonatal intensive care units. Embleton and Cooke 16 also found that discharge weight, length and head circumference were significantly related to higher proteincontaining formulas.…”

Section: Discussionmentioning

confidence: 99%

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Randomized trial of enteral protein and energy supplementation in infants less than or equal to 1250 g at birth

Brumberg

Kowalski²,

Troxell-Dorgan

et al. 2010

J Perinatol

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Objective: To determine if enteral protein and energy supplementation would significantly improve weight gain as compared with energy supplementation alone in p1250 g infants.Study Design: Inclusion criteria were birth weight (BW) p1250 g, postnatal age X14 days, diet of X75% enteral nutrition (fortified human milk or formula) and either failure to regain BW or weight gain<15 g kg À1 per days. Infants were randomized to a multinutrient supplement that provided increased protein and energy (P/E) intake or energy alone (medium chain triglyceride oil, MCT). Growth rates were compared at the end of the 4-week study period.Result: Of 30 eligible infants, 23 were enrolled, 12 received MCT (BW ¼ 862 ± 252 g, mean ± s.d.) and 11 received P/E (BW ¼ 879 ± 241 g). Significantly higher protein intake (P/E ¼ 3.5±0.3 g kg À1 per day, MCT ¼ 3.0±0.5 g kg À1 per day) and better growth (P/E ¼ 17.0 ± 2.4 g kg À1 per day, MCT ¼ 11.5±4.8 g kg À1 per day) were observed in the P/E group.Conclusion: These data are consistent with the importance of providing additional daily protein intake to achieve increased postnatal growth in very low birth weight infants experiencing slow growth.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Randomized trial of enteral protein and energy supplementation in infants less than or equal to 1250 g at birth

Brumberg

Kowalski²,

Troxell-Dorgan

et al. 2010

J Perinatol

View full text Add to dashboard Cite

show abstract

“…When growth of preterm infants lags behind expected growth (that is, growth like the fetus), it is almost always protein that is limiting growth. [21][22][23] Energy, on the other hand, provided that intakes are at least 90 to 100 kcal kg À1 per day, is seldom limiting for growth. Therefore, the inadequate levels of actual protein intakes observed in the present study offer an explanation of why preterm infants fail to grow adequately in spite of receiving adequate energy intakes.…”

Section: Discussionmentioning

confidence: 99%

Preterm infants fed fortified human milk receive less protein than they need

2009

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Objective: The aim of this study was to compare the actual nutrient intakes observed in a previously reported study with assumed nutrient intakes based on the customary assumptions about the composition of human milk.Study Design: Fortified human milk is assumed to provide adequate amounts of nutrients for premature infants. This assumption holds if milk has the composition of milk expressed by mothers of premature infants during weeks 2 to 3 of lactation. The assumption does not necessarily hold for milk expressed after 2 to 3 weeks lactation. It also does not hold for donor milk, which is typically provided by mothers of term infants. The size of the disparity between assumed and actual nutrient intakes is not known. Actual nutrient intakes were available for 32 preterm infants participating in the study. Assumed nutrient intakes were calculated for these infants by substituting assumed nutrient concentrations for observed nutrient concentrations. Data were compared separately for each of the 3 study weeks.Result: Actual protein intakes were significantly and consistently lower than assumed protein intakes during each study week. The differences in mean intakes were large, ranging from 0.5 to 0.8 g kg À1 per day. Differences in energy intake were small and not consistently significant.Conclusion: Actual intakes of protein by preterm infants fed fortified human milk are substantially lower than assumed intakes. The discrepancy may in part explain why preterm infants frequently show postnatal growth failure.

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“…4,5 Early parenteral amino-acid administration improves postnatal growth and decreases extrauterine growth restriction (EUGR). [6][7][8] Matching the catabolic rate of protein prevents negative protein balance. Studies have shown that achieving close to 3 g kg À1 per day of protein shortly after birth decreases postnatal weight loss, leads to an earlier return to birth weight and improves weight at 36 weeks postmenstrual age.…”

Section: Introductionmentioning

confidence: 99%

Nutritional strategies and growth in extremely low birth weight infants with bronchopulmonary dysplasia over the past 10 years

et al. 2011

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Objective: Changes in nutritional strategies over the past decade have been shown to improve postnatal growth in extremely low birth weight (ELBW) infants. We showed 10 years ago that the majority of these ELBW infants with bronchopulmonary dysplasia (BPD) suffer postnatal growth failure. We theorized that recent changes in nutritional support strategies would positively affect growth outcomes in ELBW infants with BPD.Study Design: A retrospective study of 88 ELBW infants with BPD. Nutritional data, postnatal growth and BPD severity were compared across three cohorts: (1) weight gain p14 g kg À1 per day, (2) 14.1 to 16 g kg À1 per day and (3) X16 g kg À1 per day from return to birth weight through discharge. We also compared these to a historical cohort.Result: In all, 73% of current subjects grew at or above fetal rates. There was less extrauterine growth restriction (EUGR) by weight and head circumference for those ELBW infants with BPD receiving higher amounts of protein. Aggressive early TPN and receipt of caloric-dense milk seemed to be the 'new' nutritional strategies improving growth for current ELBW infants with BPD compared with those 10 years ago.Conclusion: Despite a diagnosis of BPD, improved nutritional strategies have enhanced postnatal growth in infants at high risk for EUGR.

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Intersite Differences in Weight Growth Velocity of Extremely Premature Infants

Cited by 150 publications

References 31 publications

Randomized trial of enteral protein and energy supplementation in infants less than or equal to 1250 g at birth

Randomized trial of enteral protein and energy supplementation in infants less than or equal to 1250 g at birth

Preterm infants fed fortified human milk receive less protein than they need

Nutritional strategies and growth in extremely low birth weight infants with bronchopulmonary dysplasia over the past 10 years

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