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Nutritional support for extremely low-birth weight infants: abandoning catabolism in the neonatal intensive care unit

van den Akker, Chris HP; Vlaardingerbroek, Hester; van Goudoever, Johannes B

Current Opinion in Clinical Nutrition & Metabolic Care: May 2010 - Volume 13 - Issue 3 - p 327–335
doi: 10.1097/MCO.0b013e328337d925
Paediatrics: Edited by Berthold V. Koletzko and Raanan Shamir

Purpose of review Obviously, the ultimate goal in neonatology is to achieve a functional outcome in premature infants that is comparable to healthy term-born infants. As nutrition is one of the key factors for normal cell growth, providing the right amount and quality of nutrients could prove pivotal for normal development. However, many premature infants are catabolic during the first week of life, which has directly been linked to growth failure, disease, and suboptimal long-term outcome. This review describes the progress in research on parenteral nutrition for premature infants with a focus on amino acids and the influence of nutrition on later outcome.

Recent findings Although randomized clinical trials on early nutrition for premature infants remain relatively sparse, evidence is accumulating on its beneficial effects both on the short-term and long-term. However, some research also warns for adverse effects.

Summary Despite the fact that substantially improved nutritional therapies for preterm neonates have been implemented, still, some reluctance exists when it comes to providing high amounts of nutrition to the most immature infants. Pros and cons are outlined, as well as deficits in knowledge, when it comes to providing the optimal nutrient strategy in the first postnatal phase.

Division of Neonatology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands

Correspondence to Johannes B. van Goudoever, MD, PhD, Professor of Pediatrics/Neonatology, Chief of Neonatology, Erasmus MC-Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands Tel: +31 10 7036077; fax: +31 10 7036811; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.