title: Higher urinary excretion of essential amino acids in preterm infants fed protein hydrolysates.
abstract: OBJECTIVE
  Protein hydrolysates have been introduced in preterm formulae, but it is not clear whether they are needed for the feeding of preterm infants. We designed a randomized, controlled trial to test the effects of a preterm formula with hydrolysed cow's milk proteins on short-term growth and urinary and plasma amino acids levels.
  
  
  METHODS
  Infants with a birthweight < or = 1750 g and gestational age < or = 34 wk fed a conventional preterm infant formula (formula B) or a hydrolysed formula (formula A). Weight was measured daily; length, head circumference, mid-arm circumference and total skinfold thickness were measured weekly. Blood and urine were analysed for amino acid concentrations at start, 14 and 28 d.
  
  
  RESULTS
  Twenty-one infants met the criteria for randomization. The daily feeding volumes were: formula A 172.8 +/- 5.6 vs formula B 170.1 +/- 2.8 ml/kg/d. Infants fed with formula A showed slower weight gain (17.4 +/- 3.4 vs 20.5 +/- 3.3 g/kg/d; p = 0.045) and lower mean change in Z-scores for weight (-0.18 +/- 0.16 vs 0.00 +/- 0.09; p = 0.009) and for head circumference (-0.06 +/- 0.13 vs 0.06 +/- 0.13; p = 0.049). After 14 d, infants receiving formula A had statistically significant higher urinary levels of essential amino acids compared to infants receiving formula B.
  
  
  CONCLUSIONS
  Our results support the hypothesis of less nutritional value of hydrolysed versus conventional preterm formulae. Higher renal excretion of essential amino acids may be one of the mechanisms involved. These findings must be confirmed by further studies with larger sample sizes and protein hydrolysates with different degrees of hydrolysis.
authors.affiliation: Division of Neonatology, Department of Paediatrics, Catholic University of the Sacred Heart, Rome, Italy. luca.maggio@tin.it
authors.forename: L
authors.initials: L
authors.lastname: Maggio
authors.forename: A A
authors.initials: AA
authors.lastname: Zuppa
authors.forename: G
authors.initials: G
authors.lastname: Sawatzki
authors.forename: R
authors.initials: R
authors.lastname: Valsasina
authors.forename: W
authors.initials: W
authors.lastname: Schubert
authors.forename: G
authors.initials: G
authors.lastname: Tortorolo
mesh_terms: D000601:Amino Acids, Essential / Q000097:blood / Q000652:urine; D002657:Child Development / Q000187:drug effects; D005260:Female; D006801:Humans; D041943:Infant Formula / Q000008:administration & dosage / Q000737:chemistry; D007230:Infant, Low Birth Weight / Q000254:growth & development* / Q000378:metabolism*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development* / Q000378:metabolism*; D008297:Male; D008894:Milk Proteins / Q000008:administration & dosage* / Q000737:chemistry; D011492:Protein Hydrolysates / Q000008:administration & dosage*; D015430:Weight Gain / Q000187:drug effects
chemical_list: D000601:Amino Acids, Essential; D008894:Milk Proteins; D011492:Protein Hydrolysates