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Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants

Journal of Perinatology volume 26, pages 436–442 (2006)Cite this article

Abstract

Objective:

To compare postnatal growth and nutritional deficits after the implementation of two different nutritional strategies in two consecutives periods of time.

Methods:

An early and aggressive nutritional regimen was used in a cohort of 117 very low birth weight (VLBW) infants. Amino acids were administered at the rate of 1.5 g/kg/day along with 5.6 mg/k/min of glucose flow on day 1 of life, and progressively increased to 4 g/kg/day and 13 mg/kg/min. Intravenous lipids were started at 0.5 g/kg/day at 24 h from birth, and increased to 3.5 g/kg/day; enteral feeding was begun at day 1 of life. Uni- and multivariate analyses were used to compare this group with the conventional group of 65 VLBW infants conservatively fed.

Results:

Univariate analysis showed that in the aggressive group there was a 66% reduction in the risk of post natal malnutrition at 40 weeks of postmenstrual age (OR 0.34; 95% CI 0.17–0.67). This difference persisted in the multivariate analysis. Energy and protein deficits were lower in the aggressive group (P<0.001).

Conclusions:

Early and aggressive introduction of total parenteral nutrition and enteral feeding resulted in better growth in weight, length and head circumference, and a reduction of nutritional deficits at 40 weeks of postmenstrual age.

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Acknowledgements

We thank Dr Ruben Alvaro, Professor of Pediatrics, University of Manitoba at Winnipeg, for help with manuscript and useful comments.

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Authors and Affiliations

  1. Department of Neonatology, Hospital Sarda, Buenos Aires, Argentina

    A Dinerstein, R M Nieto, C L Solana, G P Perez, L E Otheguy & A M Larguia

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  1. A Dinerstein
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  2. R M Nieto
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  3. C L Solana
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  4. G P Perez
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  5. L E Otheguy
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  6. A M Larguia
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Correspondence to A Dinerstein.

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Dinerstein, A., Nieto, R., Solana, C. et al. Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants. J Perinatol 26, 436–442 (2006). https://doi.org/10.1038/sj.jp.7211539

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