SupplementNutritional Recommendations for the Late-Preterm Infant and the Preterm Infant after Hospital Discharge
Section snippets
Nutritional Requirements for the Late-Preterm Infant
A variety of terms have been used to describe preterm infants born at a number of different intervals between 32 and 36 weeks' gestation (ie, “late preterm,” “near term,” “marginally preterm,” “moderately preterm,” “minimally preterm,” and “mildly preterm”). Only the terms “moderately preterm” and “late preterm” are defined well and should be used. The term “late-preterm infants” describes infants born between 34.0 and <37.0 weeks' gestation, and “moderately preterm” describes infants born
Growth and Quality of Growth
Extrauterine growth retardation (EUGR) describes postnatal growth of preterm infants that is less than the expected growth of a fetus at the same postconceptional age. It is a major problem that occurs in 60%-100% of preterm births globally.24, 25, 26, 27, 28 EUGR has been defined at discharge as growth values <10th percentile or <−2 SD from the mean of intrauterine growth expectation. It has also been defined as a change in z-score of >−1 SD or >−2 SD from birth to discharge.29 The latter
How to Monitor the Postdischarge Infant
Accurate serial measurements of weight, length, and head circumference plotted precisely on validated growth charts facilitate early identification of potential nutritional or health problems after hospital discharge. To ensure accuracy, measurements should be made by trained personnel who use standardized techniques. Expensive equipment is not necessary.81
Recommendations for Preterm Infants after Hospital Discharge
Guidelines for all preterm newborn infants should be similar because postconceptional nutritional needs are very similar. Therefore, the recommendations below are appropriate for all groups of preterm infants, except where indicated otherwise.
Author Disclosures
All authors received an honorarium from Mead Johnson Nutrition for attendance, presentation, and manuscript preparation. All authors have participated to the review of the available data and to the writing of the manuscript.
References (86)
- et al.
Glucose metabolism in the late preterm infant
Clin Perinatol
(2006) - et al.
Place of birth and variations in management of late preterm (“near-term”) infants
Semin Perinatol
(2006) Feeding problems in the late preterm infant
Clin Perinatol
(2006)The paradox of breastfeeding-associated morbidity among late preterm infants
J Obstet Gynecol Neonatal Nurs
(2011)Neurodevelopmental outcome of the late preterm infant
Clin Perinatol
(2006)- et al.
Lipid needs of preterm infants: updated recommendations
J Pediatr
(2013) - et al.
Postnatal growth failure in preterm infants: recovery of growth and body composition after term
Early Hum Dev
(2008) - et al.
Weight growth velocity of very low birth weight infants: role of gender, gestational age and major morbidities
Early Hum Dev
(2009) - et al.
Is term newborn body composition being achieved postnatally in preterm infants?
Early Hum Dev
(2009) - et al.
Use of a body proportionality index for growth assessment of preterm infants
J Pediatr
(2009)
Early nutritional support and outcomes in ELBW infants
Early Hum Dev
Fortification of maternal milk for very low birth weight (VLBW) pre-term neonates
Early Hum Dev
Human milk and clinical outcomes in VLBW infants: how compelling is the evidence of benefit?
Semin Perinatol
Bone mineralization and growth are enhanced in preterm infants fed an isocaloric, nutrient-enriched preterm formula through term
Am J Clin Nutr
Nutritional needs of premature infants: current issues
J Pediatr
Neonatal factors predicting childhood height in preterm infants: evidence for a persisting effect of early metabolic bone disease?
J Pediatr
Vitamin A status of preterm infants during infancy
Am J Clin Nutr
Growth curves: how to best measure growth of the preterm infant
J Pediatr
Feeding preterm infants today for later metabolic and cardiovascular outcomes
J Pediatr
Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition
J Pediatr Gastroenterol Nutr
Dietary Reference Intakes
Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development
Pediatrics
“Late-preterm” infants: a population at risk
Pediatrics
Positive effect of NICU admission on breastfeeding of preterm US infants in 2000 to 2003
J Perinatol
Relativity of nuclear factor-kappaB (P65/Rel-A) and angiotensin II type 1 receptor expression in early stage of lesions of adriamycin nephrosis in young rats and the effects of intervention [in Chinese]
Zhonghua Er Ke Za Zhi
Interneonatal intensive care unit variation in growth rates and feeding practices in healthy moderately premature infants
J Perinatol
Postnatal malnutrition and growth retardation: an inevitable consequence of current recommendations in preterm infants?
Pediatrics
Late preterm birth is a risk factor for growth faltering in early childhood: a cohort study
BMC Pediatr
ABM clinical protocol #10: breastfeeding the late preterm infant (34(0/7) to 36(6/7) weeks gestation) (first revision June 2011)
Breastfeed Med
The effect of supplementation of docosahexaenoic acid and arachidonic acid on visual acuity and neurodevelopment in larger preterm infants
Chang Gung Med J
Early childhood development of late-preterm infants: a systematic review
Pediatrics
Protein, amino acid, and other nitrogen compounds
Protein requirements of very low birth weight infants
J Pediatr Gastroenterol Nutr
Energy
Calcium, magnesium, phosphorus, and vitamin D
Postnatal weight increase and growth velocity of very low birthweight infants
Arch Dis Child Fetal Neonatal Ed
Extrauterine growth restriction in preterm infants of gestational age < or =32 weeks
Pediatr Int
Multicenter study of the nutritional status of premature infants in neonatal intensive care unit in China: report of 974 cases [in Chinese]
Zhonghua Er Ke Za Zhi
Growth of preterm born children
Horm Res
Postnatal growth failure in preterm infants: ascertainment and relation to long-term outcome
J Perinat Med
Altered body composition in preterm infants at hospital discharge
Acta Paediatr
Body composition and its components in preterm and term newborns: a cross-sectional, multimodal investigation
Am J Hum Biol
Cited by (79)
The Role of the Neonatal Registered Dietitian Nutritionist: Past, Present, and Future
2023, Clinics in PerinatologyEffects of relaxation therapy on maternal psychological status and infant growth following late preterm and early-term delivery: a randomized controlled trial
2023, American Journal of Clinical NutritionDisorders of Neonatal Mineral Metabolism and Metabolic Bone Disease
2023, Principles of NeonatologyLong-Term Impact of Early Nutritional Management
2022, Clinics in PerinatologyCitation Excerpt :The decision regarding fortification or supplementation for infants receiving mother’s milk should be individualized to a particular infants’ clinical history and growth. Serial monitoring of growth parameters, including weight, length, and head circumference on validated growth curves, is critical.78 Fortification and/or supplementation with nutrient-enriched postdischarge formula should be considered until infants demonstrate adequate catch-up growth.79
Please see the Author Disclosures at the end of this article.