Feeding the premature infant - general principles

• Published in: Pediatric annals 1983, Vol.12 (1), p.46-47
• Main Authors: Ostertag, Susan G, Frayer, William W
• Format: Article
• Language: English
• Subjects: Body Composition; Body Weight; breast milk; enteral feeding; growth; Humans; infant feeding; Infant Food; infant formulas; Infant Nutritional Physiological Phenomena; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; infants; Milk, Human - analysis; nutrient density; nutrient intake; nutrient requirements; nutrient sources; Nutrition; Pregnancy; premature birth; Premature Infants; Water; Young Children
• ISSN: 0090-4481; 1938-2359
• DOI: 10.3928/0090-4481-19830101-04

Small premature infants have special nutritional requirements. Current knowledge is this area related to nutritional requirements, functioning of the digestive tract and new product formulation are discussed. Basic goals and objectives have been to produce weight gain in these infants to parallelthat of the full term infant. The various nutrients that a fetus accumulates during gestation are known; this information can be used to evaluate the proper amounts of nutrients that a premature infant should have at a given gestational ageto duplicate both fetal growth rate and fetal body composition. Enzymatic and functional deficiencies also must be evaluated. Human milk has unique qualities which make it very compatible with premature input growth requirements. Overall energy intake is affected by cold stress, physical activity and feeding. Approximately 110/150 Kcal/kg/day is required for growth. Therefore, a calorically dense formula must be used to obtain enough calories for growth. Fluid loads must be evaluated but usually a 100 cc/kg/day is baseline and adjusted for each infant. Protein composition of human milk is basically why a soft, easily digested protein that can be readily propulsed. "Humanized" formulas should contain 60% whey. Fat must provide essential fatty acids and a source of concentrated calories. A formula must provide both lonmg and medium chain triglycerides. Vegetable oils are good sources if human milk is unavailable. Calcium, phosphorus, magnesium and zinc must be obtained in amounts sufficient to produce 3rd-trimester-like bone growth and mineralization. Iron, zinc and copper from breast milk may not be sufficient to meet long-term growth requirements. Iron supplementation begining at 2-4 weeks often both is recommended in the amount of 2mg/Kg/day of a ferrous sulfate preparation. Vitamin A-C-D drops should be given to all premature infants; vitamin E requirements are infant specific. Infant formulas reflect the special nutritional needs and functional immaturity of the gastrointestinal tract of the preterm. Feeding methods depend on the ability of the infant to suck; gavage and nipple feeding are 2 possibilities. Periodic evaluation of body weight, length and head circumference must be done to determine if growth is occurring. (kbc)