New perspectives in the nutrition of premature and low birth weight infants.

In summary the following can be stated: (1) The comparable large number of premature and low birth weight infants leads in many countries to a public health problem. (2) Prematurity is an unphysiological state which causes some peculiarities in digestive and metabolic functions which in turn have implications on nutrition. (3) Under normal circumstances an intake of about 115-130 kcal/kg b.w./day meets the energy requirements. (4) For the so-called healthy low birth weight infant with a birth weight of 1.5 kg or more 2.9 to g protein/kg b.w./day seem to be adequate. Small for gestational age infants tolerate higher, severely ill low or very low birth weight infants only much smaller amounts or protein. (5) Quality of gain in weight has become a central issue in neonatal nutrition. Data available so far indicate the key role of energy and protein intake. (6) Due to the high requirements for growth the premature and low birth weight infant has greater needs for almost all other nutrients compared to term infants. (7) If human milk is fed - whether from the infant's own mother or pooled - it should at least be supplemented with protein, calcium, phosphorus and sodium as otherwise the high requirements could not be covered. (8) The scientific work done over the last decade has made available so-called premature formulas. (9) Only a very few bodies have issued guidelines on the nutrition of low birth weight infants, the most comprehensive one which has just been published by the ESPGAN. (10) Clinical trials with a premature formula which was formulated according to those guidelines confirmed the theoretical considerations of ESPGAN. (11) Final goals for nutrition of premature and low birth weight infants remain to be clarified by future scientific work. There is, however, considerable evidence that the diet fed to premature or low birth weight infants influences their future quality of life.