Energy requirements in sick preterm babies.

The energy requirements of healthy preterm babies are well documented in the literature. However, the clinical load in neonatal intensive care units is due to sick preterm infants requiring prolonged mechanical ventilation, many of whom will develop bronchopulmonary dysplasia. It is this group in which knowledge of energy requirements is scanty. This group also has poor energy reserves and is often intolerant of enteral and parenteral nutrition. In this article, we will review methods of measurement of energy expenditure, methodological problems when applied to ill infants and published results of energy expenditure measurements in sick preterm babies. We will review the link between energy reserves, energy intake and energy expenditure. The problems of undernutrition in early postnatal life and possible consequences in adult life will be discussed.