Current nutritional strategies for preterm infants with very low and extremely low birth weight

Abstract

The growth rate of infants born preterm should match the growth rate of healthy fetuses of the same gestational age. However, despite many existing clinical guidelines and dietary protocols, preterm infants almost invariably experience postnatal growth restriction. To ensure optimal growth and development of preterm infants, it has become essential to revise nutritional strategies. For preterm infants with extremely low and very low birth weight, it is recommended to initiate parenteral nutrition within the first hours of life, as well as to initiate early enteral nutrition directly in the delivery room with mother’s colostrum using buccal and cotton swabs. If possible, to increase the volume of enteral nutrition, to enrich breast milk, preferably with liquid fortifiers and/or human milk-based fortifiers, and to optimize supplementation with additional minerals. This review presents the scientific rationale for nutrient requirements, practical recommendations and strategies for parenteral and enteral nutrition in preterm infants, current recommendations for initial and maximum macro- and micronutrient gestational requirements. Key words: parenteral nutrition, enteral nutrition, preterm infant, nutrients, micronutrients, breast milk fortifiers