Physical growth and biochemical indicators of protein adequacy in exclusively breastfed neonates weighing less than 1500 g.

The objective of our study was to evaluate biochemical indicators of protein adequacy and the growth pattern in very low birthweight infants, weighing less than 1500 g, who were exclusively breastfed by their mother in the first 4 months of infancy in a tertiary level referral neonatal unit. The study design was descriptive. The study population comprised neonates admitted to the referral neonatal unit by 48 h of age, weighing less than 1500 g, whose mothers were willing to breastfeed and in whom enteral feeds could be given by day 6 of life. Detailed history, clinical evaluation and anthropometry were recorded and blood samples drawn for serum total proteins, serum albumin and blood urea nitrogen (BUN). All infants were given feeds as per the Unit policy. Infants were discharged when they were exclusively suckling and showed a positive trend in weight gain. Follow-up longitudinally for 4 months included clinical evaluation, growth velocity, biochemical indicators of protein adequacy, and occurrence of any morbidity. Growth parameters were compared with available postnatal growth standards. The mean velocity of weight gain for all neonates for the first 4 months was 19.78 g/day or 14.78 g/kg/day. The mean velocity of gain after regaining birthweight was 23.2 g/day. Mean velocity of gain in length and head circumference was 0.84 cm/week and 0.71 cm/week, respectively. Serum total proteins, albumin and BUN were within the normal range. No infant developed hypoproteinemia or hypoalbuminemia at any time during the study period. All infants obtained sufficient volume of milk from their mothers and could be successfully breastfed until 4 months of age. The velocity of growth of the neonates was comparable to the available reference standards. Indicators of protein metabolism were within normal limits. Thus, exclusive feeding of mother's own milk can be strongly recommended for very low birthweight babies particularly in the weight group 1251-1500 g.