title: Implementation of nutritional strategies decreases postnatal growth restriction in preterm infants.
abstract: BACKGROUND
  Prevention of postnatal growth restriction of very preterm infants still represents a challenge for neonatologists. As standard feeding regimens have proven to be inadequate. Improved feeding strategies are needed to promote growth. Aim of the present study was to evaluate whether a set of nutritional strategies could limit the postnatal growth restriction of a cohort of preterm infants.
  
  
  RESULTS
  We performed a prospective non randomized interventional cohort study. Growth and body composition were assessed in 102 very low birth weight infants after the introduction of a set of nutritional practice changes. 69 very low birth weight infants who had received nutrition according to the standard nutritional feeding strategy served as a historical control group. Weight was assessed daily, length and head circumference weekly. Body composition at term corrected age was assessed using an air displacement plethysmography system. The cumulative parenteral energy and protein intakes during the first 7 days of life were higher in the intervention group than in the historical group (530 ± 81 vs 300 ± 93 kcal/kg, p<0.001 and 21 ± 2.9 vs 15 ± 3.2 g/kg, p<0.01). During weaning from parenteral nutrition, the intervention group received higher parental/enteral energy and protein intakes than the historical control group (1380 ± 58 vs 1090 ± 70 kcal/kg; 52.6 ± 7 vs 42.3 ± 10 g/kg, p<0.01). Enteral energy (kcal/kg/d) and protein (g/kg/d) intakes in the intervention group were higher than in the historical group (130 ± 11 vs 100 ± 13; 3.5 ± 0.5 vs 2.2 ± 0.6, p<0.01). The negative changes in z score from birth to discharge for weight and head circumference were significantly lower in the intervention group as compared to the historical group. No difference in fat mass percentage between the intervention and the historical groups was found.
  
  
  CONCLUSIONS
  The optimization and the individualization of nutritional intervention promote postnatal growth of preterm infants without any effect on percentage of fat mass.
authors.affiliation: Neonatal Intensive Care Unit, Department of Clinical Science and Comunity Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. paola.roggero@unimi.it
authors.forename: Paola
authors.initials: P
authors.lastname: Roggero
authors.forename: Maria L
authors.initials: ML
authors.lastname: Giannì
authors.forename: Anna
authors.initials: A
authors.lastname: Orsi
authors.forename: Orsola
authors.initials: O
authors.lastname: Amato
authors.forename: Pasqua
authors.initials: P
authors.lastname: Piemontese
authors.forename: Nadia
authors.initials: N
authors.lastname: Liotto
authors.forename: Laura
authors.initials: L
authors.lastname: Morlacchi
authors.forename: Francesca
authors.initials: F
authors.lastname: Taroni
authors.forename: Elisa
authors.initials: E
authors.lastname: Garavaglia
authors.forename: Beatrice
authors.initials: B
authors.lastname: Bracco
authors.forename: Massimo
authors.initials: M
authors.lastname: Agosti
authors.forename: Fabio
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000886:Anthropometry; D001823:Body Composition; D001835:Body Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008297:Male