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Optimizing Early Nutritional Support Based on Recent Recommendations in VLBW Infants and Postnatal Growth Restriction

Senterre, Thibault; Rigo, Jacques

Journal of Pediatric Gastroenterology & Nutrition: November 2011 - Volume 53 - Issue 5 - p 536–542
doi: 10.1097/MPG.0b013e31822a009d
Original Article: Hepatology and Nutrition

Objective: The aim of this study was to evaluate postnatal growth up to discharge in very low birth weight infants after optimizing nutritional support based on recent nutritional recommendations.

Patients and Methods: A prospective, nonrandomized, consecutive, and observational study in infants weighing <1250 g.

Results: One hundred two infants were included during a 2-year period (birth weight 1005 ± 157 g, gestational age 28.5 ± 1.9 weeks). First-day nutritional intake was 38 ± 6 kcal/kg/day with 2.4 ± 0.3 g/kg/day of protein. Mean intake during the first week of life was 80 ± 14 kcal/kg/day with 3.2 ± 0.5 g/kg/day of protein. On average from birth to discharge, 122 ± 10 kcal/kg/day and 3.7 ± 0.2 g/kg/day of protein were administered. Postnatal weight loss was limited to the first 3 days of life, and birth weight was regained after 7 days in average. Catch-up occurred after the second week in all groups of very low birth weight infants. Small-for-gestational age infants demonstrated an earlier and higher weight gain, allowing a rapid catch-up growth. The same proportion of infants was small-for-gestational age at birth and at discharge (20%, P = 0.74).

Conclusions: This study confirmed that the first week of life is a critical period to promote growth and that early nutrition from the first day of life is essential. Postnatal weight loss may be limited and subsequent growth may be optimized with a dramatic reduction of postnatal growth restriction.

Department of Neonatology, University of Liege, CHU de Liège, CHR de la Citadelle, Liège, Belgium.

Address correspondence and reprint requests to Thibault Senterre, MD, Service Universitaire de Néonatologie, CHR de la Citadelle, Boulevard du Douzième de Ligne, 1, 4000 Liège, Belgique (e-mail: Thibault.Senterre@chu.ulg.ac.be).

Received 4 March, 2011

Accepted 20 April, 2011

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN