Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-28T22:22:19.293Z Has data issue: false hasContentIssue false

46 - Post-hospital nutrition of the preterm infant

Published online by Cambridge University Press:  10 December 2009

Patti J. Thureen
By
Diane M. Anderson  and
Richard J. Schanler
Edited by
William W. Hay
Patti J. Thureen
Affiliation:
University of Colorado at Denver and Health Sciences Center
Diane M. Anderson
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Houston, TX
Richard J. Schanler
Affiliation:
Schneider Children’s Hospital at North Shore, North Shore University Hospital, Manhasset, NY and Albert Einstein College of Medicine, Bronx, NY
William W. Hay
Affiliation:
University of Colorado at Denver and Health Sciences Center
Get access

Summary

Post-hospital nutrition of the preterm infant

Precise nutrient requirements and achievable growth remain to be defined for the premature infant post-hospital discharge. While fetal growth serves as the standard for the infant less than 37 weeks gestation and breastfeeding meets the needs of the healthy term infant, neither goal meets the needs of the premie graduate. The graduate of the newborn intensive care unit (NICU) frequently enters into the home setting at a physical size which is significantly less than that of the fetus of the same postmenstrual age. Nutrient need may be further altered by gender, ethnicity, hospital course and post hospital clinical status.

The limited number of investigations on nutrition post-hospital discharge differ in their infant population, study diet, duration of study diet, and final results. Post discharge formulas have recently been developed and may meet the nutrient demands for selected premature infants. Continued monitoring of the infant's dietary intake, anthropometric measurements, and clinical status will help to determine if the infant's needs are met or if nutrient supplementation is indicated.

Growth

Premature infants can grow at the fetal growth rate of at least 15 g kg−1day−1 in the NICU. This rate results in growth that parallels fetal growth, but because adequate weight gain commences only after 1–2 weeks it does not result in catch-up growth during the hospital stay. Although most premature infants begin life appropriately grown, they are frequently discharged at a weight less than the 10th percentile for age.

Type
Chapter
Information
Neonatal Nutrition and Metabolism , pp. 654 - 662
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Heird, W. C.Determination of nutritional requirements in preterm infants, with special reference to “catch-up” growth. Semin. Neonatal. 2001;6:365–75.CrossRefGoogle ScholarPubMed
Klein, C. J.Nutrient requirements for preterm infant formulas. J. Nutr. 2002;132:1395S–577S.CrossRefGoogle ScholarPubMed
Cooke, R. J., Embleton, N. D., Griffin, I. J., Wells, J. C., McCormick, K. P.Feeding preterm infants after hospital discharge: growth and development at 18 months of age. Pediatr. Res. 2001;49:719–22.CrossRefGoogle ScholarPubMed
Ehrenkranz, R. A., Younes, N., Lemons, J. A.et al.Longitudinal growth of hospitalized very low birth weight infants. Pediatrics 1999;104:280–9.CrossRefGoogle ScholarPubMed
Fenton, T. R.A new growth chart for preterm infants: Babson and Benda's chart updated with recent data and a new format. bone mineral mass Pediatrics 2003;3:13.Google Scholar
Cazacu, A., Fraley, J. K., Schanler, R. J.We are inadequately nourishing healthy low birth weight infants. Pediatr. Res. 2001;49:343A.Google Scholar
Embleton, N. E., Pang, N., Cooke, R. J.Postnatal malnutrition and growth retardation: an inevitable consequence of current recommendations in preterm infants?Pediatrics 2001;107:270–3.CrossRefGoogle ScholarPubMed
Casey, P. H., Kraemer, H. C., Bernbaum, J., Yogman, M. W., Sells, J. C.Growth status and growth rates of a varied sample of low birth weight, preterm infants: a longitudinal cohort from birth to three years of age. J. Pediatr. 1991;119:599–605.CrossRefGoogle ScholarPubMed
Hack, M., Weissman, B., Breslau, N.et al.Health of very low birth weight children during their first eight years. J. Pediatr. 1993;122:887–92.CrossRefGoogle ScholarPubMed
Hack, M., Flannery, D. J., Schluchter, M.et al.Outcomes in young adulthood for very-low-birth-weight infants. New Engl. J. Med. 2002;346:149–57.CrossRefGoogle ScholarPubMed
Hirata, T., Bosque, E.When they grow up: the growth of extremely low birth weight (≤1000 gm) infants at adolescence. J. Pediatr. 1998;132:1033–5.CrossRefGoogle ScholarPubMed
Hack, M., Schluchter, M., Cartar, L.et al.. Growth of very low birth weight infants to age 20 years. Pediatrics 2003;112: e30–8.CrossRefGoogle ScholarPubMed
Hack, M., Breslau, N., Weissman, B.et al.. Effect of very low birthweight and subnormal head size on cognitive abilities at school age. New Engl. J. Med. 1991;325:231–7.CrossRefGoogle ScholarPubMed
Carver, J. D., Wu, P. Y. K., Hall, R. T.et al.Growth of preterm infants fed nutrient-enriched or term formula after hospital discharge. Pediatrics 2001;107:683–9.CrossRefGoogle ScholarPubMed
Cooke, R. J., Griffin, I. J., McCormick, K.et al.Feeding preterm infants after hospital discharge: Effect of dietary manipulation on nutrient intake and growth. Pediatr. Res. 1998;43:355–60.CrossRefGoogle Scholar
Lucas, A., Fewtrell, M. S., Morley, R.et al.Randomized trial of nutrient-enriched formula versus standard formula for postdischarge preterm infants. Pediatrics 2001;108:703–11.CrossRefGoogle ScholarPubMed
Lucas, A., Bishop, N. J., King, F. J., Cole, T. J.Randomised trial of nutrition for preterm infants after discharge. Arch. Dis. Child. 1992;67:324–7.CrossRefGoogle ScholarPubMed
Bishop, N. J., King, F. J., Lucas, A.Increased bone mineral content of preterm infants fed with a nutrient enriched formula after discharge from hospital. Arch. Dis. Child. 1993; 68: 573–8.CrossRefGoogle ScholarPubMed
Fewtrell, M. S., Cole, T. J., Bishop, N. J., Lucas, A.Neonatal factors predicting childhood height in preterm infants: Evidence for a persisting effect of early metabolic bone disease?J. Pediatr. 2000;137:668–73.CrossRefGoogle ScholarPubMed
Schanler, R. J., Shulman, R. J., Lau, C.Feeding strategies for premature infants: beneficial outcomes of feeding fortified human milk versus preterm formula. Pediatrics 1999;103:1150–7.CrossRefGoogle ScholarPubMed
Cooke, R. J., McCormick, K., Griffin, I. J.et al.Feeding preterm infants after hospital discharge: Effect of diet on body composition. Pediatr. Res. 1999;46:461–4.CrossRefGoogle ScholarPubMed
Griffin, I. J.Postdischarge nutrition for high risk neonates. Clin. Perinatol. 2002;29:327–44.CrossRefGoogle ScholarPubMed
Griffin, I. J. and Abrams, S. A.Iron and breastfeeding. Pediatr. Clin. N. Am. 2001;48:401–13.CrossRefGoogle ScholarPubMed
American Academy of Pediatrics, Committee on Nutrition. Nutritional needs of the preterm infant. In Kleinman, R. E., ed. Pediatric Nutrition Handbook. 5th edn. American Academy of Pediatrics; 2004;23–54.Google Scholar
Chan, G. M.Growth and bone mineral status of discharged very low birth weight infants fed different formulas or human milk. J. Pediatr. 1993;123:439–43.CrossRefGoogle ScholarPubMed
Fewtrell, M. S., Morley, R., Abbott, R. A.et al.Catch-up growth in small-for-gestational-age term infants: a randomized trial. Am. J. Clin. Nutr. 2001;74:516–23.CrossRefGoogle ScholarPubMed
Morley, R., Fewtrell, M. S., Abbott, R. A.Neurodevelopment in children born small for gestational age: a randomized trial of nutrient-enriched versus standard formula and comparison with a reference breastfed group. Pediatrics 2004;113:515–21.CrossRefGoogle ScholarPubMed
American Academy of Pediatrics, Committee on Fetus and Newborn. Hospital discharge of the high-risk neonate: proposed guidelines. Pediatrics 1998;102:411–17.CrossRef
Hall, R. T. (2001) Nutritional follow-up of the breastfeeding premature infant after hospital discharge. Pediatr. Clin. N. Am. 2001;48:453–60.CrossRefGoogle ScholarPubMed
Cox, J. H., Doorlag, D. Nutritional care at transfer and discharge. In Groh-Wargo, S., Thompson, M., Cox, J., eds. Nutritional Care for High-Risk Newborns. Rev. 3rd edn. Chicago: Precept Press, Inc.;2000:549–65.Google Scholar
Dusick, A. M., Poindexter, B. B., Ehrenkranz, E. A., Lemons, J. A.Growth failure in the preterm infant: can we catch up?Semin. Perinatol. 2003;27:302–10.CrossRefGoogle ScholarPubMed
American Academy of Pediatrics, Committee on Nutrition. Breastfeeding. In Kleinman, R. E. ed. Pediatric Nutrition Handbook 5th edn. American Academy of Pediatrics;2004:55–85.Google Scholar
Theriot, L. (2000). Routine nutrition care during follow-up. In Groh-Wargo, S., Thompson, M., and Cox, J. eds. Nutritional Care for High-Risk Newborns. Rev. 3rd. Chicago: Precept Press, Inc.;2000:567–83.Google Scholar
Wang, Z., Sauve, R. S.Assessment of postneonatal growth in VLBW infants: selection of growth references and age adjustment for prematurity. Can. J. Pub. Health. 1998;89:109–14.Google ScholarPubMed
Odgen, C. L., Kuczmarski, R. J., Flegal, K. M.et al.Centers for disease control and prevention 2000 growth charts for the United States: Improvements to the 1977 National Center for Health Statistics Version. Pediatrics 2002;109:45–60.Google Scholar
Sherry, B., Mei, A., Grummer-Strawn, L., Dietz, W. H.Evaluation of and recommendations for growth references for very low birth weight (≤1500 g) infants in the United States. Pediatrics 2003;111:750–8.CrossRefGoogle Scholar
Fomon, S. J., Nelson, S. E. In ed. Fomon, S. J.Nutrition of Normal Infants. St. Louis: Mosby;1993:36–84.

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Post-hospital nutrition of the preterm infant
    • By Diane M. Anderson, Department of Pediatrics, Baylor College of Medicine, Houston, TX, Richard J. Schanler, Schneider Children’s Hospital at North Shore, North Shore University Hospital, Manhasset, NY and Albert Einstein College of Medicine, Bronx, NY
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.047
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Post-hospital nutrition of the preterm infant
    • By Diane M. Anderson, Department of Pediatrics, Baylor College of Medicine, Houston, TX, Richard J. Schanler, Schneider Children’s Hospital at North Shore, North Shore University Hospital, Manhasset, NY and Albert Einstein College of Medicine, Bronx, NY
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.047
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Post-hospital nutrition of the preterm infant
    • By Diane M. Anderson, Department of Pediatrics, Baylor College of Medicine, Houston, TX, Richard J. Schanler, Schneider Children’s Hospital at North Shore, North Shore University Hospital, Manhasset, NY and Albert Einstein College of Medicine, Bronx, NY
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.047
Available formats
×