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Feeding Routes for Preterm Infants in the Neonatal Unit 123

Figure 4.4.1 Preterm infant in an incubator Committee on Nutrition 2010), which provides
recommendations for 1000–1800 g preterm infants.
These guidelines differ from those described in
Table 4.4.2 in that they recommend higher protein
and vitamin D intakes.

Feeding Routes for Preterm Infants
in the Neonatal Unit

The feeding route or routes used for preterm infants
will depend on gestation, size and condition at birth
(Table 4.4.3). Where possible, all infants will receive
enteral nutrition as soon as clinically indicated.

Table 4.4.1 Classification of preterm and low-birthweight infants

Preterm Born before 37 weeks gestation
Low birthweight (LBW)
Very low birthweight (VLBW) Birthweight: 1500–2500 g
Extremely low birthweight (ELBW)
Small for gestational age (SGA) Birthweight: 1000–1500 g

Intrauterine growth restriction (IUGR) Birthweight: <1000 g

Birthweight below the 9th centile for gestational age. Can result
from a number of causes such as infection and genetic reasons

Born with a low weight but may show normal head and length
growth depending on how long there has been a placental
deficiency. Often at high risk of feeding problems as there may have
been redirection of blood flow from the gut to brain and other
organs

Table 4.4.2 Comparison of daily nutritional requirements of term infants
with preterm infants feeding orally or enterally

Fluid (mL/kg) Term Low birthweight and Extremely low
Energy (kcal/kg) 150 very low birthweight birthweight
Protein (g/kg) 96
Sodium (mg/kg) 2.1 150–220 150–220
Potassium (mg/kg) 35 110–130 130–150
133 3.4–4.2 3.8–4.4
69–115 69–115
78–177 78–177

From Tsang et al. (2005).