The panel discussion also focused at highlighting the advantages and disadvantages, optimal intakes, and practical recommendations for various enteral nutrition supplementation strategies. This was followed by the selection of a group of neonatologists, pediatricians, and nutrition experts, who convened in August 2016 to brainstorm and address the various challenges in providing optimal nutrition to preterm LBW infants. Objectives and MethodsĬonsidering the significant contribution of nutrition to the development of preterm newborn LBW infants, a key opinion leader who has extensive expertise in the related domain reached out to other experts who had proficiency in various areas related to the topic/s proposed to be discussed during the consensus meeting. Barker’s hypothesis also states that infants with LBW are at a higher risk of coronary heart disease, hypertension, and type 2 diabetes in adulthood ( 16, 17). Impaired weight and growth in preterm infants are significantly associated with adverse neurodevelopmental outcomes in later life ( 15). In a preterm infant, poor nutrition is associated with poorer head growth persistent smaller head size results in poor psychomotor and mental skills, higher rates of cerebral palsy, and autism ( 14). Nutrition is essential for growth, metabolism, and immunity in a preterm newborn low birth weight (LBW) infant ( 11– 13). Nutrition-An Important Factor Influencing Developmental Outcomes in Preterm Infants This consensus summary serves as a useful guide to clinicians in addressing the challenges and providing optimal nutrition to preterm LBW infants.Īlthough there has been an improvement in the overall mortality in extremely premature infants in recent times, there is a rising need to develop newer strategies for lowering the potential complications of preterm birth ( 10).
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The following were the primary recommendations of the panel: (1) enteral feeding is safe and may be preferred to parenteral nutrition due to the complications associated with the latter however, parenteral nutrition may be a useful adjunct to enteral feeding in some critical cases (2) early, fast, or continuous enteral feeding yields better outcomes compared to late, slow, or intermittent feeding, respectively (3) routine use of nasogastric tubes is not advisable (4) preterm infants can be fed while on ventilator or continuous positive airway pressure (5) routine evaluation of gastric residuals and abdominal girth should be avoided (6) expressed breast milk (EBM) is the first choice for feeding preterm infants due to its beneficial effects on cardiovascular, neurological, bone health, and growth outcomes the second choice is donor pasteurized human milk (7) EBM or donor milk may be fortified with human milk fortifiers, without increasing the osmolality of the milk, to meet the high protein requirements of preterm infants (8) standard fortification is effective and safe but does not fulfill the high protein needs (9) use of targeted and adjustable fortification, where possible, helps provide optimal nutrition (10) optimizing weight gain in preterm infants prevents long-term cardiovascular complications (11) checking for optimal weight and sucking/swallowing ability is essential prior to discharge of preterm infants and (12) appropriate counseling and regular follow-up and monitoring after discharge will help achieve better long-term health outcomes. A group of neonatologists, pediatricians, and nutrition experts convened to discuss and frame evidence-based recommendations for optimizing nutrition in preterm low birth weight (LBW) infants. Early administration of optimal nutrition to preterm birth survivors lowers the risk of adverse health outcomes and improves cognition in adulthood.
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Appropriate nutrition is essential for the growth and development of preterm infants. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts.
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5Medical and Scientific Affairs, Nestle Nutrition, South Asia Region, Gurgaon, India.2Institute of Child Health, UCL, London, United Kingdom.1Cloudnine Hospital, Bangalore, Karnataka, India.