Energy balance, nitrogen balance, and growth in preterm infants fed expressed breast milk, a premature infant formula, and two low-solute adapted formulae.

Abstract

SUMMARY Energy balance, nitrogen balance, and growth studies were done in 37 preterm infants (20 of very low birthweight) who were fed on expressed breast milk or on one of 3 formulae each of different composition, including a special premature formula and a highly adapted 'humanised' formula. The variability of breast milk composition was such that it would have been difficult to predict the infants' protein and energy intakes under normal nursing conditions. All measured parameters of nutritional performance were best in infants fed on the 'premature' formula and were reflected in greater weight gain, linear growth, and head growth. The nitrogen balance data suggest that the highly adapted formula, which had a protein content comparable with that of mature human milk, contained too little protein for small preterm infants.

Feeding Premature Infants with Human Milk or Preterm Milk Formula

“…Furthermore, the growth of the former group was closer to the intrauterine growth rates [11,22], not only for weight but also for length and head circumference. Similar rates of growth have been reported by French et al [9] using a similar formula designed for pre term infants, whilst Brooke et al [6] demon strated an even greater increase in growth velocity in babies given a preterm formula with a mean daily feed volume of 200 ml/kg.…”

“…Previous reports [6,9] have shown that such preparations accelerate the growth of preterm infants. However, there has not yet been a comprehensive study in which the growth rates of formula and human milk fed preterm infants have been examined in con junction with measurements of circulating concentrations of amino acids, metabolic fuels, and regulatory peptides.…”

Protein Requirements in Preterm Infants: Effect of Different Levels of Protein Intake on Growth and Body Composition

“…Previous studies suggested that energy intakes of ‫051ف‬ kcal/kg/d in association with higher protein intakes promoted improved weight gain compared with intakes of 120 kcal/kg/d (16,17,21). Several studies have also shown growth advantages to increased amounts of dietary protein (13,(15)(16)(17)21). However, the greatest differences were demonstrated in studies where intakes of Ͻ3 g/kg/d were compared with those Ͼ3.5 g/kg/d.…”

“…Previous controlled studies assessing protein requirements in preterm infants have examined growth during initial hospital stay (12)(13)(14)(15)(16)(17). However, infants born preterm are usually discharged home before they have reached a corrected age of term.…”

Sequential Changes in the Antimicrobial Protein Concentrations in Human Milk during Lactation and Its Relevance to Banked Human Milk

“…This may be relevant to the feeding of preterm and sick neonates where the protective capabilities of human milk may outweigh its nutritional benefits. Satisfactory nutritional intake for these infants may in fact be better supplied using artificial feeds at present (18). It is, however, recognized that there is an immunochemical difference between the milk of women delivering prematurely (preterm milk) and those delivering at term (19).…”