Effects of high versus standard early protein intake on growth of extremely low birth weight infants.
OBJECTIVE
Early provision of protein has been shown to limit catabolism and could improve growth. Our objective was to determine whether early aggressive protein intake improved growth outcomes of extremely low birth weight (ELBW) infants.


METHODS
ELBW infants were included in the study if they had no major congenital anomalies or renal failure and were still hospitalized at 36 weeks postmenstrual age. In 25 infants (HP) the early protein intake was planned to be 20% greater than in 31 historical controls (SP).


RESULTS
The 2 groups were similar in the baseline characteristics. The mean protein intake during the first 14 days of life was significantly greater in the HP group (3.1 +/- 0.2 vs 2.5 +/- 0.2 g/kg/d; P<0.0001). HP group showed lower postnatal weight loss (-3.1%; 95% confidence interval [CI] -5.9, -0.2) and earlier regain of birth weight (-4.1 days; 95% CI -6.6, -1.7). Mean blood urea nitrogen and bicarbonate levels were similar; mean serum glucose level was lower in the HP group (-21,7 mg/dL; 95% CI -41.9,-1.5). HP infants had a reduced fall in weight z score (-0.57; 95% CI -1.01, -0.12) and in length z score (-0.51; 95% CI -0.97, -0.05) from birth to discharge.


CONCLUSIONS
Early high protein intake was associated with improved weight and length growth outcomes at discharge. These findings highlight the benefits of aggressive protein intake immediately after birth.
Maggio
Luca
L
Division of Neonatology, Department of Paediatrics, Catholic University of the Sacred Heart, Rome, Italy. luca.maggio@fastwebnet.it
Cota
Francesco
F
Gallini
Francesca
F
Lauriola
Valeria
V
Zecca
Chiara
C
Romagnoli
Costantino
C
D001827:Body Height; D001835:Body Weight; D004044:Dietary Proteins / Q000627:therapeutic use*; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D008297:Male
D004044:Dietary Proteins