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Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary

Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Appropriate nutrition is essential for the growth and development of pre...

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Autores principales: Kumar, R. Kishore, Singhal, Atul, Vaidya, Umesh, Banerjee, Saswata, Anwar, Fahmina, Rao, Shashidhar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445116/
https://www.ncbi.nlm.nih.gov/pubmed/28603716
http://dx.doi.org/10.3389/fnut.2017.00020
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author Kumar, R. Kishore
Singhal, Atul
Vaidya, Umesh
Banerjee, Saswata
Anwar, Fahmina
Rao, Shashidhar
author_facet Kumar, R. Kishore
Singhal, Atul
Vaidya, Umesh
Banerjee, Saswata
Anwar, Fahmina
Rao, Shashidhar
author_sort Kumar, R. Kishore
collection PubMed
description Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Appropriate nutrition is essential for the growth and development of preterm infants. Early administration of optimal nutrition to preterm birth survivors lowers the risk of adverse health outcomes and improves cognition in adulthood. A group of neonatologists, pediatricians, and nutrition experts convened to discuss and frame evidence-based recommendations for optimizing nutrition in preterm low birth weight (LBW) infants. The following were the primary recommendations of the panel: (1) enteral feeding is safe and may be preferred to parenteral nutrition due to the complications associated with the latter; however, parenteral nutrition may be a useful adjunct to enteral feeding in some critical cases; (2) early, fast, or continuous enteral feeding yields better outcomes compared to late, slow, or intermittent feeding, respectively; (3) routine use of nasogastric tubes is not advisable; (4) preterm infants can be fed while on ventilator or continuous positive airway pressure; (5) routine evaluation of gastric residuals and abdominal girth should be avoided; (6) expressed breast milk (EBM) is the first choice for feeding preterm infants due to its beneficial effects on cardiovascular, neurological, bone health, and growth outcomes; the second choice is donor pasteurized human milk; (7) EBM or donor milk may be fortified with human milk fortifiers, without increasing the osmolality of the milk, to meet the high protein requirements of preterm infants; (8) standard fortification is effective and safe but does not fulfill the high protein needs; (9) use of targeted and adjustable fortification, where possible, helps provide optimal nutrition; (10) optimizing weight gain in preterm infants prevents long-term cardiovascular complications; (11) checking for optimal weight and sucking/swallowing ability is essential prior to discharge of preterm infants; and (12) appropriate counseling and regular follow-up and monitoring after discharge will help achieve better long-term health outcomes. This consensus summary serves as a useful guide to clinicians in addressing the challenges and providing optimal nutrition to preterm LBW infants.
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spelling pubmed-54451162017-06-09 Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary Kumar, R. Kishore Singhal, Atul Vaidya, Umesh Banerjee, Saswata Anwar, Fahmina Rao, Shashidhar Front Nutr Nutrition Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Appropriate nutrition is essential for the growth and development of preterm infants. Early administration of optimal nutrition to preterm birth survivors lowers the risk of adverse health outcomes and improves cognition in adulthood. A group of neonatologists, pediatricians, and nutrition experts convened to discuss and frame evidence-based recommendations for optimizing nutrition in preterm low birth weight (LBW) infants. The following were the primary recommendations of the panel: (1) enteral feeding is safe and may be preferred to parenteral nutrition due to the complications associated with the latter; however, parenteral nutrition may be a useful adjunct to enteral feeding in some critical cases; (2) early, fast, or continuous enteral feeding yields better outcomes compared to late, slow, or intermittent feeding, respectively; (3) routine use of nasogastric tubes is not advisable; (4) preterm infants can be fed while on ventilator or continuous positive airway pressure; (5) routine evaluation of gastric residuals and abdominal girth should be avoided; (6) expressed breast milk (EBM) is the first choice for feeding preterm infants due to its beneficial effects on cardiovascular, neurological, bone health, and growth outcomes; the second choice is donor pasteurized human milk; (7) EBM or donor milk may be fortified with human milk fortifiers, without increasing the osmolality of the milk, to meet the high protein requirements of preterm infants; (8) standard fortification is effective and safe but does not fulfill the high protein needs; (9) use of targeted and adjustable fortification, where possible, helps provide optimal nutrition; (10) optimizing weight gain in preterm infants prevents long-term cardiovascular complications; (11) checking for optimal weight and sucking/swallowing ability is essential prior to discharge of preterm infants; and (12) appropriate counseling and regular follow-up and monitoring after discharge will help achieve better long-term health outcomes. This consensus summary serves as a useful guide to clinicians in addressing the challenges and providing optimal nutrition to preterm LBW infants. Frontiers Media S.A. 2017-05-26 /pmc/articles/PMC5445116/ /pubmed/28603716 http://dx.doi.org/10.3389/fnut.2017.00020 Text en Copyright © 2017 Kumar, Singhal, Vaidya, Banerjee, Anwar and Rao. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Nutrition
Kumar, R. Kishore
Singhal, Atul
Vaidya, Umesh
Banerjee, Saswata
Anwar, Fahmina
Rao, Shashidhar
Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary
title Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary
title_full Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary
title_fullStr Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary
title_full_unstemmed Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary
title_short Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary
title_sort optimizing nutrition in preterm low birth weight infants—consensus summary
topic Nutrition
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445116/
https://www.ncbi.nlm.nih.gov/pubmed/28603716
http://dx.doi.org/10.3389/fnut.2017.00020
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