Page 131 - MHF-FeedingMinds-final.indd
P. 131
4.4
Preterm Infants
Summary
●● Preterm infants are those born before 37 weeks maternal breast milk to aid growth and ensure
gestation. adequate nutritional status.
●● The nutritional needs of preterm infants are ●● If breast milk is unavailable there are preterm
higher per kg body weight than those of term formulas and nutrient-enriched postdischarge
infants and vary depending on the infant’s formula milks which have been designed to
gestation and size. meet the specific nutritional needs of preterm
infants.
●● Babies who are born very preterm and/or very
small are likely to require neonatal parenteral ●● Development of oral feeding is individual and
nutrition while establishing enteral feeds. dependent on many factors, including
gestation and size at birth and the medical
●● Maternal breast milk, either enterally via a condition and history of the baby.
feeding tube or orally, provides health benefits.
●● Weaning can begin at an earlier
●● Mothers may need skilled support to express post-conception age than in term infants as
breast milk for their preterm infant. preterm infants need a more nutrient-dense
diet earlier.
●● Most infants weighing less than 1500 g (1.5 kg)
at birth require breast milk fortifiers added to
Classification of Preterm and kilograms and the need to support energy
Small-for-Gestational-Age Infants expenditure and growth. As preterm infants have
not accumulated the body stores of nutrients that
Infants born preterm (less than 37 weeks gestation) term infants accumulate during the third trimester
or with a low birthweight (LBW), below 2500 g of pregnancy, they have higher nutrient needs per
(2.5 kg), have special nutritional needs which vary kilogram of body weight than term infants.
according to the infant’s maturity and any medical Adequate protein and energy are required for
complications that are present at birth or develop growth. An optimal protein:energy ratio is at least
subsequently. The terms used to classify preterm 3 g protein/kg for every 100 kcal/kg.
and low-birthweight infants are defined in Table
4.4.1. The nutritional requirements of preterm infants
are compared with those of term infants in Table
Nutritional Requirements 4.4.2.
The energy and nutrient requirements for any Recent enteral nutrition guidelines for the
infant are calculated based on their body weight in neonate have been published by the European
Society of Paediatric Gastroenterology, Hepatology
and Nutrition (ESPGHAN) in 2010 (ESPGHAN
