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Nutritional Concerns

Nutritional concerns are paramount during the neonatal period for the pre-term infant. Nutrition is an equally important issue for these children as they leave the neonatal intensive care unit (NICU) to embark into the world. A premature infant may increase his/her body weight up to ten fold during the first year of life. This rapid growth results in increased energy requirements - which may be difficult to meet considering the frequency of feeding problems encountered within this population. Lack of adequate nutrition often leads to deficiencies in essential fatty acids (EFA), linoleic acid, and linolenic acid, which are associated with hypomyelination and subsequent motor and cognitive impairment.

Coexisting deficiency in various micronutrients, such as Zinc, may further delay neurodevelopment. Inadequate postnatal nutrition contributes to growth failure. Many infants (up to 40%) remain below the tenth percentile for growth at 18-22 months of age. This growth failure is associated with poor neurodevelopmental progress. Fortified human breast milk is recognized as the optimum basic nutrition postnatally for the premature infant, or, when not possible, nutrient-fortified formula. This should be continued for at least nine months post term in order to promote optimum growth and development. It is important for the clinician to evaluate feeding problems, nutritional status, and growth progress of premature infants thoroughly during follow-up visits.

Dusick, A.M., Poindexter, B.B., Ehrenkranz, R.A., & Lemons, J.A. (2003). Growth failure in the preterm infant: Can we catch up? Seminars in Perinatology, 27(4), 302-310.

Perlman, J. (2001). Neurobehavioral deficits in premature graduates of intensive care-potential medical and neonatal environmental risk factors. Pediatrics, 108(6), 1342.