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

Agostoni, C*; Buonocore, G; Carnielli, VP; De Curtis, M§; Darmaun, D||; Decsi, T; Domellöf, M#; Embleton, ND**; Fusch, C††; Genzel-Boroviczeny, O‡‡; Goulet, O§§; Kalhan, SC||||; Kolacek, S¶¶; Koletzko, B##,1; Lapillonne, A***; Mihatsch, W†††; Moreno, L‡‡‡; Neu, J§§§; Poindexter, B||||||; Puntis, J¶¶¶; Putet, G###; Rigo, J****,1; Riskin, A††††; Salle, B‡‡‡‡; Sauer, P§§§§; Shamir, R||||||||; Szajewska, H¶¶¶¶; Thureen, P####; Turck, D*****; van Goudoever, JB†††††,1; Ziegler, EE‡‡‡‡‡for the ESPGHAN Committee on Nutrition

Journal of Pediatric Gastroenterology and Nutrition: January 2010 - Volume 50 - Issue 1 - p 85–91
doi: 10.1097/MPG.0b013e3181adaee0
Original Articles: Hepatology and Nutrition

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, 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.

*Department of Pediatrics, San Paolo Hospital, University of Milan, Italy

Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

Division of Neonatology, Department of Clinical Sciences, Salesi Hospital, Polytechnic University of Marche, Ancona, Italy

§University of Rome, Italy

||Centre Hospitalier, Universitaire de Nantes, France

Department of Paediatrics, University of Pecs, Hungary

#Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden

**Newcastle Neonatal Service, Department of Child Health, University of Newcastle Upon Tyne, Royal Victoria Infirmary, Newcastle Upon Tyne, UK

††Ernst-Moritz-Arndt-University, Greifswald, Germany

‡‡Neonatologie Klinikum der Universität München, Germany

§§Pediatric Gastroenterology-Hepatology and Nutrition, Reference Center for Rare Digestive Disease, Hôpital Necker-Enfants Malades/AP-HP, University of Paris 5–René Descartes, Paris, France

||||Department of Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA

¶¶University Children's Hospital, Zagreb Medical University, Croatia

##Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany

***Hôpital Saint-Vincent de Paul, Paris, France

†††Department of Paediatrics, Deaconry Hospital, Schwaebisch Hall, Germany

‡‡‡Escuela Universitaria de Ciencias de la Salud, Zaragoza, Spain

§§§Department of Paediatrics, University of Florida, Gainesville

||||||Section of Neonatal, Department of Pediatrics, Indiana University School of Medicine, Indianapolis

¶¶¶Leeds General Infirmary, Leeds, UK

###Service de Néonatologie et de Réanimation Néonatale, Hôspital de la Croix Rousse, Lyon

****CHR Citadelle Néonatologie, University of Liege, Belgium

††††Bnai Zion Medical Center, Haifa, Israel

‡‡‡‡Service de Medicine de la Reproduction, Hôspital Edouard Herriot, Lyon

§§§§Department of Paediatrics, University Medical Centre Groningen, The Netherlands

||||||||Division of Gastroenterology and Nutrition, Schneider Children's Medical Center, Tel-Aviv University, Tel Aviv, Israel

¶¶¶¶2nd Department of Pediatrics, Medical University of Warsaw, Poland

####University of Colorado, Health Sciences Center, Denver, Colorado

*****Jeanne de Flandre Children's Hospital/University of Lille, France

†††††Erasmus MC–Sophia Children's Hospital, Department of Paediatrics, Rotterdam, The Netherlands

‡‡‡‡‡Department of Pediatrics, Fomon Infant Nutrition Unit, Children's Hospital, University of Iowa, Iowa City.

1 Project steering committee member.

Received 26 January, 2009

Accepted 16 February, 2009

Address correspondence and reprint requests to Prof Dr J.B. van Goudoever, MD, PhD, Division of Neonatology, Department of Peadiatrics, Sophia Children's Hospital–Erasmus Medical Center, Rotterdam, The Netherlands.

All meetings and the writings of manuscripts were performed without any participation of representatives or employees of commercial enterprises, and the supporting companies in no way influenced subjects and contents of the guideline.

A scientific workshop held to discuss the draft recommendations with invited expert guests was financially supported by unrestricted educational grants donated by Danone Baby Nutrition (then Nutricia Baby Foods), Mead Johnson Nutritionals, and Nestlé Nutrition and administered by the Charitable Child Health Foundation, Munich, Germany (

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the JPGN Web site (

The authors report no conflicts of interest.

© 2010 Lippincott Williams & Wilkins, Inc.