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After Discharge Home from the Neonatal Unit 129
Preterm infants often need slow milk flow teats, 2. Nutrient-enriched post-discharge
supportive positioning and careful monitoring to formula
achieve safe and efficient feeding, especially if their
breathing and bottlefeeding are less well Nutrient-enriched post-discharge formula may be
coordinated. Parents will therefore need support to given to preterm infants still in hospital who have
feed safely and effectively. As they progress, been on a preterm formula and have reached
bottlefed infants can be fed according to their 2–2.5 kg. They contain less energy and protein than
hunger cues as for term infants. preterm formulas but are higher in energy, protein,
vitamins and minerals, especially calcium and
Formula Milks for Preterm phosphorus and iron, than standard formulas for
Infants term infants. They are used to support the higher
nutritional requirements for catch-up growth in
There are two types of formula used on neonatal units preterm infants once they have been discharged home.
for preterm infants. They are summarized in Table
4.4.6. They are available both as:
1. Preterm formulas ●● sterile ready-to-feed and
Preterm formulas are for supervised hospital use ●● non-sterile powder that must be reconstituted
only and only available in a sterile, ready-to-feed with boiled water.
format. They have been designed to meet the
nutritional requirements of preterm infants There are two brands available.
providing:
After Discharge Home from the
●● adequate energy and protein levels with a Neonatal Unit
protein-to-energy ratio to optimize growth
Once discharged home there is no consensus on the
●● phosphate and calcium levels at the optimum optimal nutritional requirements for a preterm
ratio for bone mineralization infant. Some preterm infants may go home with some
nutritional deficits but most will demand feed orally
●● required vitamin, mineral and iron content. and should be allowed to ‘catch up’ any growth deficit
in their own time. Their nutritional intake and
Preterm formulas are usually given to infants who growth should be regularly assessed and monitored.
are <2 kg at birth.
Breastfed infants require additional vitamin
There are three brands available but most and iron supplements, as directed by the consultant
neonatal units usually just stock one brand. paediatrician or dietitian.
Table 4.4.6 Types of formula milk available for preterm infants
Type of formula Examples Manufacturer Relevant compositional Used for infants with:
milk Aptamil Preterm Milupa details Preterm or
Preterm formula Nutriprem 1 Cow & Gate low-birthweight infants
SMA Gold Prem 1 SMA Nutrition Higher in energy and in hospital
Nutrient-enriched nutrients than term
post-discharge Nutriprem 2 Cow & Gate formulas and nutrient- Discharged preterm and
formulas SMA Gold Prem 2 SMA Nutrition enriched post-discharge low-birthweight infants
formulas
Higher in nutrients than
term – particularly
vitamin D and iron
