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Extrauterine Growth Restriction and Optimal Growth of Very Preterm Neonates: State of the Art

Over the last few decades, there has been an ongoing debate over both the optimal feeding mode for very premature neonates (VPN) as well as what their optimal growth should be. Despite the American Academy of Pediatric declaring since 1997 that the growth of VPN should follow the trajectory of intra...

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Autores principales: Gounaris, Antonios K., Sokou, Rozeta, Gounari, Eleni A., Panagiotounakou, Polytimi, Grivea, Ioanna N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384682/
https://www.ncbi.nlm.nih.gov/pubmed/37513649
http://dx.doi.org/10.3390/nu15143231
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author Gounaris, Antonios K.
Sokou, Rozeta
Gounari, Eleni A.
Panagiotounakou, Polytimi
Grivea, Ioanna N.
author_facet Gounaris, Antonios K.
Sokou, Rozeta
Gounari, Eleni A.
Panagiotounakou, Polytimi
Grivea, Ioanna N.
author_sort Gounaris, Antonios K.
collection PubMed
description Over the last few decades, there has been an ongoing debate over both the optimal feeding mode for very premature neonates (VPN) as well as what their optimal growth should be. Despite the American Academy of Pediatric declaring since 1997 that the growth of VPN should follow the trajectory of intrauterine fetal growth, differences of opinion persist, feeding policies keep changing, and the growth and development of VPN remains extremely variable not only between countries, but even between neighboring neonatal units. Even the appropriate terminology to express poor postnatal growth (extrauterine growth restriction (EGR) and postnatal growth failure (PGF)) remains a subject of ongoing discussion. A number of recent publications have shown that by implementing breast milk fortification and closely following growth and adjusting nutrition accordingly, as per the consensus guidelines of the major Neonatal Societies, we could achieve growth that closely follows birth centiles. A recent position paper from EPSGAN recommending targeted nutritional support to cover the energy and protein deficits sustained by VPN during periods of critical illness further strengthens the above findings. Conclusion: We can promote better growth of VPN by ensuring a stable administration of sufficient calories and protein, especially in the first 2 weeks of life, implementing breast milk fortification, covering energy and protein deficits due to critical illness, and increasing feeding volumes as per the latest guidelines. The adoption of universal protocol for nutrition and growth of VPN is essential and will enable better monitoring of long-term outcomes for this population.
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spelling pubmed-103846822023-07-30 Extrauterine Growth Restriction and Optimal Growth of Very Preterm Neonates: State of the Art Gounaris, Antonios K. Sokou, Rozeta Gounari, Eleni A. Panagiotounakou, Polytimi Grivea, Ioanna N. Nutrients Opinion Over the last few decades, there has been an ongoing debate over both the optimal feeding mode for very premature neonates (VPN) as well as what their optimal growth should be. Despite the American Academy of Pediatric declaring since 1997 that the growth of VPN should follow the trajectory of intrauterine fetal growth, differences of opinion persist, feeding policies keep changing, and the growth and development of VPN remains extremely variable not only between countries, but even between neighboring neonatal units. Even the appropriate terminology to express poor postnatal growth (extrauterine growth restriction (EGR) and postnatal growth failure (PGF)) remains a subject of ongoing discussion. A number of recent publications have shown that by implementing breast milk fortification and closely following growth and adjusting nutrition accordingly, as per the consensus guidelines of the major Neonatal Societies, we could achieve growth that closely follows birth centiles. A recent position paper from EPSGAN recommending targeted nutritional support to cover the energy and protein deficits sustained by VPN during periods of critical illness further strengthens the above findings. Conclusion: We can promote better growth of VPN by ensuring a stable administration of sufficient calories and protein, especially in the first 2 weeks of life, implementing breast milk fortification, covering energy and protein deficits due to critical illness, and increasing feeding volumes as per the latest guidelines. The adoption of universal protocol for nutrition and growth of VPN is essential and will enable better monitoring of long-term outcomes for this population. MDPI 2023-07-21 /pmc/articles/PMC10384682/ /pubmed/37513649 http://dx.doi.org/10.3390/nu15143231 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Opinion
Gounaris, Antonios K.
Sokou, Rozeta
Gounari, Eleni A.
Panagiotounakou, Polytimi
Grivea, Ioanna N.
Extrauterine Growth Restriction and Optimal Growth of Very Preterm Neonates: State of the Art
title Extrauterine Growth Restriction and Optimal Growth of Very Preterm Neonates: State of the Art
title_full Extrauterine Growth Restriction and Optimal Growth of Very Preterm Neonates: State of the Art
title_fullStr Extrauterine Growth Restriction and Optimal Growth of Very Preterm Neonates: State of the Art
title_full_unstemmed Extrauterine Growth Restriction and Optimal Growth of Very Preterm Neonates: State of the Art
title_short Extrauterine Growth Restriction and Optimal Growth of Very Preterm Neonates: State of the Art
title_sort extrauterine growth restriction and optimal growth of very preterm neonates: state of the art
topic Opinion
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384682/
https://www.ncbi.nlm.nih.gov/pubmed/37513649
http://dx.doi.org/10.3390/nu15143231
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