title: Improving nutritional practices in premature infants can increase their growth velocity and the breastfeeding rates.
abstract: OBJECTIVE
  This study analysed the changes in growth velocity (GV) of preterm infants weighing <1500 g based on different nutritional practices over a 24-year period.
  
  
  METHODS
  A retrospective study with prospectively collected data was performed in a level three Spanish neonatal intensive care unit. Data on birthweight, gestational age (GA) and GV were collected from 1990 to 2013 and breastfeeding data were gathered from 2000. A generalised linear model corrected by GA and small for gestational age was applied. Multiple mean comparisons between the levels of the variables of interest were performed using the Tukey test.
  
  
  RESULTS
  We included 1651 children in the study. The average GA in 1990-1991 was 30.48 ± 2.89 and the average GA in 2012-2013 was 28.79 ± 2.58 (p < 0.01). Significant differences were found when we compared the adjusted GV between the first and last study periods. The most important differences appeared between 1990 and 2013, when the GV increased by 3.27 ± 0.5 g/kg/day (p < 0.01). The breastfeeding rate in 2000-2001 was 47.95% and in 2012-2013 it was 73.58% (p = 0.0002).
  
  
  CONCLUSIONS
  Introducing nutritional practices such as the increased use of breastmilk and the breastfeeding rate improved GV over the study period.
authors.affiliation: Neonatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Piris Borregas
authors.affiliation: Neonatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: López Maestro
authors.affiliation: Neonatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Torres Valdivieso
authors.affiliation: Neonatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Martínez Ávila
authors.affiliation: Neonatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Bustos Lozano
authors.affiliation: Neonatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Carmen Rosa
authors.initials: CR
authors.lastname: Pallás Alonso
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data*; D002657:Child Development; D005248:Feeding Methods; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D012189:Retrospective Studies
keywords: Breastfeeding rate; Breastmilk; Growth velocity; Nutritional practices; Preterm infant