Abstract
Our aim is to achieve a growth rate comparable to that in utero in the VLBW (<1.3 kg). Sixty-seven infants were grouped according to gestational age (GA) and birthweight, and studied from age 14 days to weight 1.8 kg. Weight, length, head circumference and skinfold thickness were measured serially. Prevention of metabolic acidosis led to a 21% greater length growth (p<0.02). Increased caloric intake from 130 to 150 cal/kg/day led to greater gains in length (to 1.08 cm/wk), body weight, and skinfold thickness (p<0.05). Plotting postnatal weight against length, curves of individuals, initially >97th centile, approached the 75th centile at 1.8 kg. Episodic hyponatremia (Na <130 mEq/1) in some infants fed “Improved” SMA S-26, 150 cal/day, was associated with decreased length growth (p <0.05 in appropriate GA infants). Increasing Na intake from 2 to 3 mEq/kg/day prevented hyponatremia without expansion of ECF space. Increased caloric intake to 180 cal/kg/day led to weekly length increments of 1.2 cm (= 50th intrauterine centile), weight increments of 200 g/week (= 45th centile, p <0.05), and a slight increase in head circumference compared to infants fed 150 cal/kg/day. Thus, by carefully controlling metabolic acidosis, hyponatremia and caloric intake intrauterine growth rates could be maintained after age 14 days in the VLBW.
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Willis, D., Roy, N., Chance, G. et al. GROWTH OF VERY LOW BIRTHWEIGHT (VLBW) INFANTS: EFFECTS OF ACIDOSIS, CALORIC INTAKE AND HYPONATREMIA. Pediatr Res 8, 452 (1974). https://doi.org/10.1203/00006450-197404000-00674
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DOI: https://doi.org/10.1203/00006450-197404000-00674