The Impact of Neonatal Illness on Nutritional Requirements-One Size Does Not Fit All.
Sick neonates are at high risk for growth failure and poorer neurodevelopment than their healthy counterparts. The etiology of postnatal growth failure in sick infants is likely multi-factorial and includes undernutrition due to the difficulty of feeding them during their illness and instability. Illness also itself induces fundamental changes in cellular metabolism that appear to significantly alter nutritional demand and nutrient handling. Inflammation and physiologic stress play a large role in inducing the catabolic state characteristic of the critically ill newborn infant. Inflammatory and stress responses are critical short-term adaptations to promote survival, but are not conducive to promoting long-term growth and development. Conditions such as sepsis, surgery, necrotizing enterocolitis, chronic lung disease and intrauterine growth restriction and their treatments are characterized by altered energy, protein and micronutrient metabolism that result in nutritional requirements that are different from those of the healthy, growing term or preterm infant.
Assistant Professor of Pediatrics, University of Minnesota Children's Hospital, 2450 Riverside Avenue; MB630 East Building, Minneapolis, MN 55454, Ph: 612-626-0644;
Sara E
SE
Ramel
Associate Professor of Pediatrics, University of Colorado School of Medicine, Aurora, CO, Ph: 303-724-0106.
Laura D
LD
Brown
Professor of Pediatrics and Child Psychology, University of Minnesota Children's Hospital, 2450 Riverside Avenue; MB630 East Building, Minneapolis, MN 55454, Ph: 612-626-0644;
Michael K
MK
Georgieff
Bronchopulmonary Dysplasia; Illness; Macronutrients; Micronutrients; Neonatal Sepsis; Nutrition; Physiology; Preterm; Protein; Stress