Department of Pediatrics, University Hospital of Ioannina, Ioannina, Greece.
Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, Ioannina, Greece.
Br J Nutr. 2023 Oct 28;130(8):1338-1342. doi: 10.1017/S0007114523000338. Epub 2023 Feb 9.
Postnatal growth failure, a common problem in very preterm neonates associated with adverse neurodevelopmental outcome, has recently been shown not to be inevitable. There is a wide discussion regarding feeding practices of very preterm neonates, specifically regarding feeding volumes and nutrients supply to avoid postnatal growth failure. Current guidelines recommend an energy intake of 115–140 kcal /kg per d with a considerably higher upper limit of 160 kcal/kg per d. The feeding volume corresponding to this energy supply is not higher than 200 ml/kg in most cases. From the other side, randomised and observational studies used higher feeding volumes, and these were associated with better weight gain and growth, while no complications were noted. Taking into account the above, nutritional practices should be individualised in each very and extremely preterm infant trying to reduce postnatal growth failure, pointing out that available data are inconclusive regarding the effect of high-volume feeds on growth. Large clinical trials are necessary to conclude in the best feeding practices of very preterm neonates.
早产儿出生后生长迟缓是一种常见问题，与不良神经发育结局相关，但最近的研究表明这种情况并非不可避免。目前对于极低体重新生儿的喂养方式存在广泛的讨论，特别是在喂养量和营养素供给方面，以避免早产儿出生后生长迟缓。目前的指南建议每天摄入 115-140kcal/kg 的能量，而摄入量上限可高达 160kcal/kg/d。在大多数情况下，为了满足这一能量供应，喂养量并不需要高于 200ml/kg。另一方面，随机和观察性研究使用了更高的喂养量，这些研究与更好的体重增加和生长有关，同时没有观察到任何并发症。考虑到这一点，应该根据每个极低和超低出生体重儿的具体情况制定营养方案，以尽量减少早产儿出生后生长迟缓的发生，同时需要指出的是，关于高容量喂养对生长的影响，现有数据尚无定论。有必要进行大型临床试验来确定最佳的极低体重新生儿喂养方法。
