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4 - Postnatal growth in preterm infants

Published online by Cambridge University Press:  10 December 2009

Patti J. Thureen
By
Richard J. Cooke
Edited by
William W. Hay
Patti J. Thureen
Affiliation:
University of Colorado at Denver and Health Sciences Center
Richard J. Cooke
Affiliation:
Department of Pediatrics, University of Tennessee Newborn Center, Memphis, Tennessee
William W. Hay
Affiliation:
University of Colorado at Denver and Health Sciences Center
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Summary

Introduction

The fundamental principle in providing nutritional support is to ensure that intake meets requirements thereby ensuring that inadequate intake is not rate-limiting on outcome. However, translating principles into practice is not simple in the preterm, particularly the very-low birth weight infant (VLBWI).

It takes time to establish adequate dietary intakes in the immature infant, and infants become malnourished during initial hospital stay. Yet, recommended dietary intakes (RDI) are based on needs for maintenance and normal growth, but no allowance is made for ‘catch-up’ growth, a critical consideration in the preterm infant. Accurate and reproducible measures of outcome also are not fully agreed upon.

Any discussion on postnatal growth in preterm infants, therefore, tends to raise more questions than answers. It is recommended that once birth weight has been regained, growth parallels that of the fetus at the same gestational age. But what is acceptable early weight loss? Is fetal growth an appropriate reference for postnatal growth? How should growth be assessed? In this chapter, these issues will be discussed, as will a few studies examining postnatal growth in this high-risk population.

Early weight loss

The importance of early weight loss cannot be underestimated. This is illustrated in Figure 4.1. A 27-week gestation 1007 g infant who regains birth weight by the end of the second week and then grows at a rate which parallels that in utero will weigh ∼541 g less than the intrauterine fetus at 37-week gestation.

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Neonatal Nutrition and Metabolism , pp. 47 - 57
Publisher: Cambridge University Press
Print publication year: 2006

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  • Postnatal growth in preterm infants
    • By Richard J. Cooke, Department of Pediatrics, University of Tennessee Newborn Center, Memphis, Tennessee
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.005
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  • Postnatal growth in preterm infants
    • By Richard J. Cooke, Department of Pediatrics, University of Tennessee Newborn Center, Memphis, Tennessee
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.005
Available formats
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  • Postnatal growth in preterm infants
    • By Richard J. Cooke, Department of Pediatrics, University of Tennessee Newborn Center, Memphis, Tennessee
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.005
Available formats
×