Postnatal Growth Curve of the Infant with Extremely Low Birth Weight Who Was Fed Enterally

Abstract

The primary objective of this study was the establishment of a postnatal growth curve for the very low-birth-weight infant. Only infants whose size was appropriate for gestational age and whose predominant form of nourishment was enteral were included in the study. Two growth curves were constructed: one for infants weighing less than 900 g (group A, birth weight 799 ± 79 [SD] g, mean gestational age 26.5 weeks), and one for infants weighing 901 to 1,100 g (group B, birth weight 1,023 ± 53 [SD] g, mean gestational age 28.5 weeks). Growth was followed over the first 50 postnatal days. Group A infants gained an average of 10.2 g/d overall during the first 50 postnatal days and group B infants gained an average of 17.1 g/d over the same period. Because the major objective of this study was construction of a growth curve for infants weighing less than 900 g, direct comparison is made with the Dancis grid (1948) as this is the only standard for this group. The growth rates of our infants were found to be more than twice that of the original prediction of Dancis.

Postnatal Growth in Infants Born Between 700 and 1,500 g

“…Time to regain birth weight was less but subsequent weight and length gain were greater than previously reported (6)(7)(8)(9)(10)(11). These findings are in part explained by the inclusion of sick infants in whom growth is limited (13) and by the improvements in nutritional support that have occured with time.…”

“…Although comparisons between this and previous studie s examining postnatal growth are difficult , some findings are similar, i.e ., the biphasic nature of the weight curve , the timing and extent of initial weight loss, and the effect of birth weight on weight gain (6)(7)(8)(9)(10)(11). The latter is important and merits examination.…”

“…Weight gain was less in the smaller «1 ,000 g) when compared to the larger (> 1,000 g) infants. Previou sly, this might have been attributed to the effects of systemic illness and/or differences in nutrient intake (9)(10)(11). Neither occurred in this study, which may implicate other factors.…”

“…Previous studies have largely examined white infants (6)(7)(8)(9)(10)(11). Ninety percent of our infants were black.…”

“…However, many changes have occurred since the elegant studies of Dancis et al (6) and Babson (7), but few infants at < 1,000 g of birth weight were observed. Recent studies have enrolled infants of <1,000g but have included infants with problems that adversely affect growth , e.g ., systemic illness and poor nutrient intake (8)(9)(10)(11).…”