Nutrition of newborns small for gestational age with human milk lyophilisate enriched human milk during the first week of life.

In 24 very low birth weight infants appropriate or small for gestational age, the metabolic response to nutrition with human milk lyophilisate enriched human milk was estimated during the first week of life. In contrast to newborns appropriate for gestational age, in newborns small for gestational age signs of metabolic overloading could be observed: increased urinary amino acid excretion and neonatal cholestasis. Both depended on the degree of fetal growth retardation. It was concluded that nutrition with human milk lyophilisate enriched human milk cannot be recommended for very low birth weight infants during the first week of life. In newborns small for gestational age the metabolic situation has to be estimated before starting a high protein diet. If the level of total bile acids amounts to more than 30 mumol/l, protein intake should be increased carefully during the first week of life.