Clinical effects of two different levels of protein intake on low-birth-weight infants

Goldman, Harold S.; Freudenthal, Roslyn; Holland, Beatrice; Karelitz, Samuel

doi:10.1016/s0022-3476(69)80222-2

Cited by 80 publications

(35 citation statements)

References 24 publications

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“…Similarly, two RCTs support a positive impact of enteral feed (breast milk or formula) fortification with protein doses of 3.8 g/kg/day [60] and 4.8 g/kg/day [55] compared to doses of 3.1 and 3.5 g/kg/day, respectively, on cognitive development, measured with developmental scales such as BNBAS and GMDS. In contrast, two follow-up studies in the 1970s [61,62] of a RCT from the 1960s [63] suggest that enteral supplementation with protein doses of 6 g/kg/day or more lead to an increase in detrimental outcomes, such as lower cognitive performance [62], fever and lethargy at 5–6 years of age. In addition to the dose, the assessment time points differ between the studies.…”

Section: Dietary Intervention Studies For Brain and Cognitive Devementioning

confidence: 99%

Early Nutritional Interventions for Brain and Cognitive Development in Preterm Infants: A Review of the Literature

Schneider

García-Ródenas

2017

Nutrients

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Adequate nutrition is important for neurodevelopmental outcomes in preterm-born infants. In this review, we aim to summarize the current knowledge on nutritional interventions initiated during the hospital stay targeting brain and cognitive development benefits in preterm human infants. Studies can broadly be split in general dietary intervention studies and studies investigating specific nutrients or nutritional supplements. In general, mother’s breast milk was reported to be better for preterm infants’ neurodevelopment compared to infant formula. The differences in methodologies make it difficult to conclude any effects of interventions with individual nutrients. Only protein and iron level studies showed some consistent findings regarding optimal doses; however, confirmatory studies are needed. This review does not support some widely accepted associations, such as that between long-chain polyunsaturated fatty acid supplementation and visual development. Clear nutritional recommendations cannot be made based on this review. However, the type of infant nutrition (i.e., breast milk versus formula or donor milk), the timing of the nutritional intervention, and the dose of the nutrient/supplement have been found to be relevant factors in determining the success of nutritional intervention studies in preterm infants.

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Section: Dietary Intervention Studies For Brain and Cognitive Devementioning

confidence: 99%

Early Nutritional Interventions for Brain and Cognitive Development in Preterm Infants: A Review of the Literature

Schneider

García-Ródenas

2017

Nutrients

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“…Though the formulae studied differed in a number of respects from breast milk, it has been concluded that the difference in growth is due principally to the absence of sufficient protein in breast milk, and it has been inferred from measurements of weight gain (5, 10,19,20), longitudinal growth (5, 1 l), and plasma protein and urea concentration (18) that preterm infants probably require about 3.5 to 4.5 g protein kg-' day-' for optimum growth (8).…”

Section: Speculationmentioning

confidence: 99%

Nitrogen Metabolism in Preterm Infants Fed Human Donor Breast Milk: the Possible Essentiality of Glycine

et al. 1981

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SummaryNitrogen metabolism was studied in three preterm infants (mean gestation 32 wk) by the method of consecutive metabolic balance. The absorption and retention of nitrogen from breast milk was measured, and protein turnover, synthesis, and breakdown were calculated from isotopic plateau of urinary urea and ammonia using an intermittent oral administration of "N-glycine. Weight gain and nitrogen retention were compared with the weight gain and nitrogen accumulated for a foetus of equivalent gestational age in utero.The average composition of the milk was 289 + 19 K J dl-' and 1.44 + 24 g protein dl-'. The intake of energy was 572 + 61 KJ kg-' day -' and of nitrogen 447 + 99 mg kg-' day-'. Stool output of nitrogen was 100 + 32 mg kg-' day-' giving an absorption of 348 + 78 mg kg-' day-', as urinary excretion was 91 + 17 mg kg-' day-' retained nitrogen was 256 2 71 mg kg-' day-', or 56% of intake.The specific weight gain was 15.6 5 2.6 g kg-' day-' and 53% of this comprised lean tissue (range 34 to 89%). In all but one study the postnatal retention of nitrogen fell far short of calculated in utero accumulation.The results of protein turnover were surprising. In six of the eight studies urinary urea failed to become enriched at all. Protein turnover calculated from the ammonia plateau was 1.94

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“…At the same time, a landmark paper by Goldman et al [8] appeared in the Journal of Pediatrics, warning about very high protein intake because of deleterious effects on IQ development. This study was a follow-up of an earlier double-blinded study, performed in 1963 [9], where less edema was observed in infants fed 6 g/kg/day of cow's milk protein, but more fever, lethargy, and poor feeding behavior as well as higher levels of plasma protein than the infants fed 3 g/kg/day of cow's milk protein in the direct postnatal phase. Specifically infants with a birth weight < 1,300 g were at risk of developing strabismus and low IQ scores.…”

Section: Preterm Formulamentioning

confidence: 95%

Nutrition for Preterm Infants: 75 Years of History

Goudoever

2018

Ann Nutr Metab

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As technology has advanced, survival rates of preterm infants have improved dramatically. Human milk was the primary source of enteral nutrition during the early days of neonatology, but the HIV/AIDS epidemic resulted in an increased use of preterm formula. More recently, the benefits of human milk were rediscovered, resulting in increased use of donor human milk as well. The awareness that human milk does not contain the amounts of nutrients to meet the high requirements of infants born premature resulted in the development of human milk fortifiers. The development of these fortifiers is still ongoing, as are alternative methods of pasteurization of donor milk. Those initiatives will increase the use of human milk with consequently short- and long-term benefits for preterm infants.

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Clinical effects of two different levels of protein intake on low-birth-weight infants

Cited by 80 publications

References 24 publications

Early Nutritional Interventions for Brain and Cognitive Development in Preterm Infants: A Review of the Literature

Early Nutritional Interventions for Brain and Cognitive Development in Preterm Infants: A Review of the Literature

Nitrogen Metabolism in Preterm Infants Fed Human Donor Breast Milk: the Possible Essentiality of Glycine

Nutrition for Preterm Infants: 75 Years of History

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