Effect of nutrition on the nutritional status in preterm infants with extremely low birth weight

Introduction. Despite the use of modern approaches to feeding preterm infants with extremely low birth weight (ELBW) with the prescription of breast milk fortifiers during breastfeeding and specialized products for preterm infants during formula feeding, postnatal delay in their physical development remains an unsolved problem. There is no consensus on the timing of complementary feeding for such infants.
Objective: to determine the peculiarities of nutritional status of ELBW infants depending on the specifics of nutrition over the first year of life.
Materials and methods. One hundred fourteen ELBW infants aged from birth to 11 months postnatal age (PNA) were examined. Patients were categorized into 2 groups: group 1 (main group) consisted of infants (n = 59) whose diets were adjusted by us depending on the degree of nutritional deficiency. The group 2 (control) consisted of infants (n = 55) who did not receive our recommendations or did not follow them. Anthropometric parameters were assessed using the INTERGROWTH-21st international growth standards until the babies reached 64 weeks of postconceptional age (PCA), and then using the WHO Anthro (2009) software. Body composition (fat and fat-free mass) was determined by air plethysmography (PEA POD, LMi, USA).
Results. Analysis of the nutritional status in ELBW infants revealed decrease in anthropometric indices by the time of discharge from the hospital; both groups had nutritional deficiencies of varying severity: the medians of body weight (BW) to PCA were –1.92 [–2.72– –1.18] and –2.18 [–3.57– –1.37]). Nutritional correction: the use of breast milk fortifiers, high-protein, high-calorie mixtures for prematurity and inclusion of certain complementary foods starting from 4 months of age allowed to significantly increasing the nutritional value of the diets of babies from the group 1 and improve their nutritional status, having corrected nutritional deficiencies by 6 months of age. The fat-free body weight (g) content increased significantly, while the amount of body fat (%) did not exceed the values characteristic of preterm infants. In the 2nd gr. by 6 months, malnutrition persisted: BW to PCA was –2.06 [–2.52– –1.66], which persisted until the end of the study (11 months).
Conclusion. Dynamic assessment of the nutritional status in ELBW infants and timely optimization of nutrition allowed correcting nutritional deficiency during a relatively short time, which can have a significant positive impact on their further growth, development, and health status.

premature infants, extremely low birth weight, nutritional status, postnatal growth retardation, body composition, fat and fat-free body weight, specialized mixtures, nutritional correction

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