Infant formulas for preterm infants: In‐hospital and post‐discharge

Abstract

The availability and composition of preterm and post-discharge formulas (PDFs) have undergone considerable changes over the last decade. Human milk, supplemented with multi-component fortifier, is the preferred feed for very preterm infants as it has beneficial effects for both short- and long-term outcomes compared with formula. If supply of mother's milk or donor milk is inadequate, a breast milk substitute specifically designed for premature infants is the next option. Preterm formula is intended to provide nutrient intakes to match intrauterine growth and nutrient accretion rates and is enriched with energy, macronutrients, minerals, vitamins, and trace elements compared with term infant formulas. Post-natal longitudinal growth failure has been reported almost universally in extremely preterm infants. Since 2009, a nutritionally enriched PDF specifically designed for preterm infants post hospital discharge with faltering growth has been available in Australia and New Zealand. This formula is an intermediary between preterm and term formulas and contains more energy (73 kcal/100 mL), protein (1.9 g/100 mL), minerals, vitamins, and trace elements than term formulas. Although the use of a PDF is based on sound nutritional knowledge, the 2012 Cochrane Systematic Review of 10 trials comparing feeding preterm infants with PDF and term formula did not demonstrate any short- or long-term benefits. Health professionals need to make individual decisions on whether and how to use PDF.

Ethical issues in hypoplastic left heart syndrome

“…1 We are concerned that this implies that parents are being and will continue to be counselled antenatally and postnatally to have surgery, rather than being given a full explanation of the risks and benefits of surgery compared with termination or palliative care after delivery. The authors' phrase about moving on from ethical dilemmas also implies that survival from surgery rather than examined quality of life will be the major determinant of future counselling.…”

“…22 October 2012 Dear Editor, I must admit to being surprised about the conflict of interest statement by one author of the recent article on infant formulas. 1 The author declares that he 'has done consultancy work for Nutricia and Wyeth Nutrition, Australia'. The final passage of the article discusses nutrition in preterm infants following discharge and the conclusion states, 'Such infants should be fed a specifically designed PDF .…”

Re: Conflicts of interest

“…1 However, stating a Conflict of Interest does not exonerate an author from trying to avoid bias in writing a review article. There is evidence that financial Conflicts of Interest are common and not always declared by authors writing about drugs.…”

“…As the lead author for the review paper on infant formula for preterm infants, 1 I am responding to the letter of Dr Simon Hauser, 2 who has raised important points regarding Conflicts of Interest. I consider it important to engage with this topic and to encourage open and honest dialogue.…”

Ensaio clínico sobre o efeito da acupuntura no nível de ansiedade de mães de prematuros em processo de lactação

“…Outra característica frequentemente desta população é a baixa escolaridade (PADOVANI et al, 2009;ROSSETTO, 2011;SISK et al, 2009;TUDEHOPE;PAGE;GILROY, 2012), também considerada como barreira para a amamentação de prematuros. Existe associação positiva entre a taxa de AM durante a hospitalização do RN pré-termo e a escolaridade materna superior a 12 anos de estudo (SISK et al, 2009).…”