Abstract 1638 Neonatal Nutrition and Metabolism II Poster Symposium, Monday, 5/3

The protein intakes of VLBW infants are typically lower than requirements, particularly when breast milk with nutrient fortifier is fed. We hypothesized that increasing the protein content of feedings (fortified breast milk, premature formula) for VLBW infants improves growth. In this double-blind study, 66 infants with birth weight < 1250g were randomly assigned to receive protein (Elementra) or lactose in the amount of 0.8 g/dl as supplements to their regular feedings. Nutritional management was otherwise by parents' choice (breast vs formula) and under the jurisdiction of the medical team. Study supplements were started when enteral feeds reached 50 ml/kg/d and ended when the infant was discharged or reached a weight of 2000 g. Blood for urea nitrogen, albumin and blood gases was obtained weekly and later biweekly. Forty-six infants completed the study. Growth was evaluated from the day feeds reached 90 kcal/kg/d to the end of the study. Results were as follows (means (SD)): (Table) It is evident that among infants fed fortified breast milk, protein supplementation led to significantly greater weight gain despite significantly lower energy intake. There was a trend toward shorter hospital stay by ∼ 4 days. Among formula-fed infants protein supplementation had no significant effect on growth. In neither group did protein have adverse effects. Serum urea nitrogen was higher in infants receiving the protein supplement, but albumin concentrations and acid-base status were not different. We conclude that breast milk fortifiers provide too little protein.

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