No abstract

SUMMARY Plasma amino acids were measured in 35 preterm infants, of whom 11 weighed less than 1000 g and 24 weighed between 1000 g and 1500 g at the time of sampling. Repeat samples were obtained in 18 at least seven days later. Seventeen infants were fed with preterm formula milk and 18 with expressed maternal breast milk at one to two hourly intervals during the study period. Formula fed infants gained weight faster than those fed on breast milk but there was little difference in amino acid patterns. Infants fed on breast milk were more likely to have concentrations of essential amino acids below the mid trimester fetal range than formula fed infants, but few infants in either feeding group had values above the fetal range. Those that did were equally distributed between both groups. Only two samples approached toxic concentrations, both in the group fed breast milk. The ratio of branched chain to aromatic amino acids was higher in the group fed on formula after correction for post conceptional age, implying that liver maturation may be accelerated by formula feeding. No correlations were found between plasma amino acid concentrations and nitrogen retention or metabolisable energy intake.The survivals of very small preterm infants are improving all the time. It is common now for babies weighing less than 1000 g at birth to survive, and there is a steadily increasing chance that an infant born weighing less than 750 g will leave hospital well. There are many problems in looking after such babies, not the least being those associated with metabolic immaturity, which makes the type, amount, and route of administration of nutrients critical. Because it is important that infants whose central nervous system is in a state *of rapid development should receive adequate nutrition, the clinical management of such babies must strike the right balance between the provision of nutrients in adequate amounts and quality for optimal growth and the possibility of harming the baby by giving more than can be satisfactorily metabolised

No abstract

No abstract

No abstract