Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants.
OBJECTIVE
To compare postnatal growth and nutritional deficits after the implementation of two different nutritional strategies in two consecutives periods of time.


METHODS
An early and aggressive nutritional regimen was used in a cohort of 117 very low birth weight (VLBW) infants. Amino acids were administered at the rate of 1.5 g/kg/day along with 5.6 mg/k/min of glucose flow on day 1 of life, and progressively increased to 4 g/kg/day and 13 mg/kg/min. Intravenous lipids were started at 0.5 g/kg/day at 24 h from birth, and increased to 3.5 g/kg/day; enteral feeding was begun at day 1 of life. Uni- and multivariate analyses were used to compare this group with the conventional group of 65 VLBW infants conservatively fed.


RESULTS
Univariate analysis showed that in the aggressive group there was a 66% reduction in the risk of post natal malnutrition at 40 weeks of postmenstrual age (OR 0.34; 95% CI 0.17-0.67). This difference persisted in the multivariate analysis. Energy and protein deficits were lower in the aggressive group (P < 0.001).


CONCLUSIONS
Early and aggressive introduction of total parenteral nutrition and enteral feeding resulted in better growth in weight, length and head circumference, and a reduction of nutritional deficits at 40 weeks of postmenstrual age.
Dinerstein
A
A
Department of Neonatology, Hospital Sarda, Buenos Aires, Argentina. alejandro.dinerstein@gmail.com
Nieto
R M
RM
Solana
C L
CL
Perez
G P
GP
Otheguy
L E
LE
Larguia
A M
AM
D000704:Analysis of Variance; D002149:Energy Intake; D004750:Enteral Nutrition; D006130:Growth Disorders / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D016015:Logistic Models; D010288:Parenteral Nutrition; D011446:Prospective Studies; D012189:Retrospective Studies; D015430:Weight Gain