Neonatal nutrition: a brief review

Schutzman, David L.; Porat, Rachel; Salvador, Agnes; Janeczko, Michael

doi:10.1007/s12519-008-0046-2

Cited by 16 publications

(10 citation statements)

References 34 publications

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“…Geralmente, elas são consumidas antes deste período. No entanto, quando utilizadas como alimentação complementar do lactente, o produto é armazenado por um período maior (SARNI, 2007;SCHUTZMAN et al, 2008;CHÁVEZ-SERVÍN et al, 2008).…”

Section: Resultsunclassified

Estabilidade dos ácidos graxos poli-insaturados presentes em fórmulas infantis comerciais

Kus¹,

Aued-Pimentel²,

Mancini‐Filho³

2011

BJFT

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ResumoA oxidação lipídica tem sido extensivamente estudada devido às alterações provocadas nos alimentos, as quais têm implicações indesejadas na saúde humana. Dentre as alterações ocorridas, destacam-se a perda dos ácidos graxos essenciais, a formação de ácidos graxos trans e a formação de compostos voláteis responsáveis pelas alterações sensoriais dos produtos alimentícios e de outros compostos não voláteis, que podem ser potencialmente tóxicos. No caso de fórmulas infantis, o aumento do conteúdo de ácidos graxos poli-insaturados de cadeia longa, a fortificação mineral, os tratamentos tecnológicos e o período de estocagem podem acelerar o processo de oxidação lipídica. O objetivo deste estudo foi avaliar a estabilidade de ácidos graxos poli-insaturados -linoleico, α-linolênico, araquidônico e docosahexaenoico -em 14 fórmulas infantis comerciais por oito meses. Adicionalmente, avaliou-se a formação dos ácidos graxos trans no período de estudo. A determinação dos lipídios totais das amostras seguiu o método de Rose Gottlieb e a quantificação dos ácidos graxos foi realizada por cromatografia gasosa com detector de ionização de chama, utilizando-se o éster metílico do ácido tricosaenoico (23:0) como padrão interno. A maioria das amostras não apresentou degradação dos ácidos graxos no período de um mês, mas ao final do estudo (oito meses), 11 das 14 amostras apresentaram diminuição do conteúdo dos ácidos graxos poli-insaturados. Observou-se o aumento dos ácidos graxos trans com o armazenamento, para algumas amostras. Os resultados indicam a necessidade de maior atenção na utilização das fórmulas infantis quando próximo o prazo de validade, pois os ácidos graxos poli-insaturados são degradados e o valor nutricional do produto poderá ser modificado. Palavras-chave: Ácido graxo poli-insaturado; Oxidação lipídica; Estabilidade oxidativa; Fórmula infantil. SummaryLipid oxidation has been extensively studied because it can promote changes in food which have undesirable implications on human health. The main changes are a loss of essential fatty acids, formation of trans fatty acids, formation of volatile compounds responsible for sensory alterations and the formation of other non-volatile products which may be potentially toxic. In infant formulas, the increasing content of long-chain polyunsaturated fatty acids, mineral fortification, technological treatments and the storage period can all accelerate lipid oxidation. The aim of this study was to evaluate the stability of the polyunsaturated fatty acids, i.e. linoleic, α-linolenic, arachidonic and docosahexaenoic in 14 commercial infant formulas for 8 months. In addition, the formation of trans fatty acids during the period studied was evaluated. The total lipid contents of the samples were determined using the Rose Gottlieb method, and the fatty acids were quantified by gas chromatography with a flame ionization detector, using the tricosanoic acid methyl ester (23:0) as the internal standard. Most of the samples showed no fatty acid degradation within the first month, ...

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Section: Resultsunclassified

Estabilidade dos ácidos graxos poli-insaturados presentes em fórmulas infantis comerciais

Kus¹,

Aued-Pimentel²,

Mancini‐Filho³

2011

BJFT

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“…To date, the conflicting results of the studies comparing continuous and intermittent bolus feeding make difficult to formulate universal recommendations regarding the best tube feeding method for premature infants with birth weight less than 1500 g. 39 During any kind of tube feeding, potential problems are reflux and aspiration, metabolic impairment, gastric perforation, vagal stimulation and bradycardia, as well as nasal erosion or palatal groove. 40 Continuous nutrition could be preferred in smaller infants (as those with a birthweight below 1250 g) or hemodynamically impaired infants; in stable growing infants nutrition can be administered intermittently as in healthy term infants. …”

Section: Discussionmentioning

confidence: 99%

Enteral nutrition for preterm infants: by bolus or continuous? An update

Bozzetti

Tagliabue

2017

Pediatr Med Chir

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Optimization of nutritional management of preterm infants is crucial for achievement of their long-term health. Enteral nutrition is preferred to total parenteral nutrition (TPN) because the former avoids complications related to vascular catheterization, sepsis, adverse effects of TPN, and fasting. Due to the lack of ability of preterm infants to coordinate suckling, swallowing, and breathing, tube feeding is necessary for most infants less than 1500 g to ensure sufficient feeding tolerance, to support optimal growth and to reduce the risk of aspiration. Therefore, feeding by orogastric or nasogastric tube using either continuous or intermittent bolus delivery of formula or human milk is common practice for these infants. Theoretical risks and benefits of both continuous nasogastric milk feeding and intermittent bolus milk feeding have been proposed. According to the literature, continuous nutrition could be preferred in smaller infants (as those with a birthweight below 1250 g) or hemodynamically impaired infants; in stable growing infants nutrition can be administered intermittently as in healthy term infants. IntroductionApproximately 8% of infants are born with a weight at birth less than 2.5 kg. 1 These infants face uncertain futures, ranging from insufficient postnatal growth to compromised neurodevelopmental outcomes. 2 Thus, optimization of their nutritional management is crucial for achievement of their long-term health and wellbeing. There is a correlation between the neurocognitive outcome and growth, for this reason an adequate nutrition is essential for the optimal growth and health. Most of severe preterm infants are discharged weighing less than the tenth percentile for age despite improvements in their nutritional management. 3 Some of them remain small to adulthood and exhibit adverse long-term developmental outcomes including learning impairments and reduced work capacity. 4,5 Because growth failure of low birth weight (LBW) infants has been attributed, in part, to the provision of inadequate levels of protein and energy, more aggressive nutritional support is now being advocated. 6 Evidence suggests that this approach is justified because early provision of amino acids to extremely LBW infants is associated with improved growth; 7 moreover provision of adequate amount of amino acid increases whole body protein synthesis and accretion rates in LBW infants. 8 Parenteral feeding allows rapid nutrition when enteral nutrition is not possible due to respiratory problems, limited gastric capacity, reduced intestinal mobility, and a perceived risk for necrotizing enterocolitis. 6 When an infant is medically stable, minimal enteral feeding is provided to prime the intestine and gradually the infant is moved from parenteral to enteral feeding until achievement of full enteral feedings.Enteral nutrition is preferred to total parenteral nutrition (TPN) because the former avoids complications related to vascular catheterization, sepsis, adverse effects of TPN, and fasting. Moreover, enteral feedin...

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“…Nevertheless, the use of a prolonged parenteral nutrition (PN) exposes infants to the metabolic and central line complications as well as to the deleterious effects of fasting on gastrointestinal system. 26,27 Late introduction of feeding may be detrimental due to lack of stimulation of the gastrointestinal tract, resulting in villous atrophy and lack of hormone and enzyme production and may not reduce the incidence of NEC. Enteral fasting can also affect the timing of full enteral feeding (FEF) and may delay hospital discharge.…”

Section: Intrauterine Growth Restriction and Preterm Infants Feeding:mentioning

confidence: 99%

Enteral feeding of intrauterine growth restriction preterm infants: theoretical risks and practical implications

Bozzetti

Tagliabue

2017

Pediatr Med Chir

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Intrauterine growth restriction (IUGR) infants are thought to have impaired gut function after birth secondary to intrauterine redistribution of the blood flow, due to placental insufficiency, with a consequent reduction of gut perfusion. For this reason, infants complicated by IUGR have been considered at higher risk of feeding intolerance. Postnatal evaluation of splanchnic perfusion, through Doppler of the superior mesenteric artery, and of splanchnic oxygenation, through near infrared spectroscopy measurements, may be useful in evaluating the persistence (or not) of the redistribution of blood flow occurred in utero. IntroductionThe term intrauterine growth restriction (IUGR) indicates the presence of a pathological process occurring in utero that inhibits fetal growth as documented by at least two fetal intra-uterine growth assessments. Fetal growth restriction (FGR) or intrauterine growth restriction is defined as the failure of the fetus to achieve its growth potential and represents one of the most debated issues in obstetrics, being in continuous search for improvement in terms of definition, classification, diagnosis and management. 1 IUGR is an important problem in perinatal medicine. It is the second cause of perinatal mortality after prematurity. The two conditions are often associated in case of iatrogenic prematurity. Fifty-two per cent of stillbirths are associated with IUGR and 10% of perinatal mortality cases in Europe are the consequence of unrecognized severe growth restriction. In developed countries, 3-7% of newborns are classified as IUGR. 2 The most common cause of IUGR is the placental obliterative vasculopathy that reduces nutrients and oxygen supply to the fetus; the causes include, but are not limited to, maternal malnutrition, maternal hypertension and idiopathic placental insufficiency. Placental insufficiency may be characterized by blood flow redistribution to the vital organs (brain, myocardium, and adrenal glands), while other organs, including the gastrointestinal tract, are deprived from sufficient blood flow. These fetuses are at increased risk of hypoxia, hypoglycemia and acidosis and also spontaneous preterm delivery. 3,4 The intrauterine growth restriction fetus: detection and monitoring Fetal monitoringThe main directions towards assessing fetal growth state can be clinical (e.g. the assessment of symphyseal-fundal height) and paraclinical (e.g. ultrasound biometry).Commonly used clinical methods for estimating fetal size are clinical palpation, fundal height measurement and ultrasonic fetal biometry. Serial ultrasound biometric recordings may be able to identify the fetus that does not reach its growth potential. Ultrasound must be considered the method of choice as it is highly reliable and reproducible. 5 The ultrasound limit for SGA or FGR is arbitrarily fixed at an estimated fetal weight (EFW) or abdominal circumference (AC) under the 3 rd , 5 th , 10 th percentile or below -2 Standard Deviation (SD) from the population standard or reference. 6 When IUGR is t...

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Neonatal nutrition: a brief review

Cited by 16 publications

References 34 publications

Estabilidade dos ácidos graxos poli-insaturados presentes em fórmulas infantis comerciais

Estabilidade dos ácidos graxos poli-insaturados presentes em fórmulas infantis comerciais

Enteral nutrition for preterm infants: by bolus or continuous? An update

Enteral feeding of intrauterine growth restriction preterm infants: theoretical risks and practical implications

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