title: Preventing postnatal growth restriction in infants with birthweight less than 1300 g.
abstract: OBJECTIVE
  To examine nutritional and growth outcomes in very preterm infants with a birthweight (BW) of ≤1300 g before and after the introduction of enhanced enteral and parenteral nutrition protocols.
  
  
  METHODS
  A comparison of two historical cohorts.
  
  
  RESULTS
  There were 153 infants in cohort 1 and 118 in cohort 2. A total of 19% were growth restricted at birth in both cohorts. Feeds advanced more quickly in cohort 2, with decreased duration of central lines and TPN; breastmilk fortification occurred sooner. Calorie and protein intakes were increased during all of the first 14 days of life. Adverse clinical outcomes were unchanged, including NEC. The proportion of infants discharged <10th percentile of expected weight, decreased from 23% to 9%. In cohort 2, the z-score for body weight decreased by 0.39, compared to an average 1.03 in cohort 1 (p < 0.001). Head circumference and body weight were also significantly improved at discharge (p < 0.01), but length was improved to a lesser degree.
  
  
  CONCLUSIONS
  Early and enhanced postnatal intravenous and enteral feeding can provide good postnatal growth among very immature infants without adverse effects. Calorie and particularly protein intake in early life could probably be further optimised.
authors.affiliation: Division of Neonatology, Sainte-Justine Hospital, Montreal, QC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Lapointe
authors.affiliation: Division of Neonatology, Sainte-Justine Hospital, Montreal, QC, Canada.|Department of Pediatrics, Sainte-Justine Hospital Research Center, University of Montreal, Montréal, QC, Canada.
authors.forename: K J
authors.identifier: http://orcid.org/0000-0001-9669-5094
authors.initials: KJ
authors.lastname: Barrington
authors.affiliation: Division of Neonatology, Sainte-Justine Hospital, Montreal, QC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Savaria
authors.affiliation: Division of Neonatology, Sainte-Justine Hospital, Montreal, QC, Canada.|Department of Pediatrics, Sainte-Justine Hospital Research Center, University of Montreal, Montréal, QC, Canada.|Clinical Ethics University of Montreal and Hôpital Sainte-Justine, Montréal, QC, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Janvier
mesh_terms: D001835:Body Weight; D001942:Breast Feeding; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D004750:Enteral Nutrition / Q000379:methods*; D006257:Head / Q000033:anatomy & histology; D006801:Humans; D041943:Infant Formula; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D010288:Parenteral Nutrition / Q000379:methods*; D015430:Weight Gain
chemical_list: D004044:Dietary Proteins
keywords: Enteral nutrition; Extreme prematurity; Growth curves; Necrotising enterocolitis; Nutrition; Total parenteral nutrition