Nutritional Requirements

Premature infants typically experience increased metabolic needs and thus require increased calories in order to thrive. While "healthy" full-term infants thrive on breast milk or standard formula providing approximately 20 calories per ounce, preterm infants (and other infants subjected to physical stresses) typically require 24 calories per ounce. This may be provided by infant formula or supplemented breast milk. Premature infants should typically receive 90-120 Kcal/kg per 24 hour period. Supplementation should follow the guidelines of 7-17% of calories from protein, 30-55% of calories from fat, and 35-65% of calories from carbohydrate. In order to insure that the infant is receiving an adequate amount of formula, the clinician should instruct the caregiver and provide caloric calculations. For example, most laypersons are not familiar with the conversion of lbs to kg, etc. (to get kg's, divide infant's weight by 2.2). The clinician should provide the information necessary for each increment in the infant's weight.

Although the mainstay of the infant's nutrition will remain breast milk or formula during the first year of life, there should be a natural progression to more solid foods. Usually infants begin with strained foods (such as "stage 1" commercial baby food) and progress to "junior" foods containing some lumps and thicker texture (stage 2 commercial baby food). Finally the infant progresses to finger foods such as soft cooked vegetables or elbow pasta. Care should be taken to monitor for food allergies which may result in a variety of related health issues, as well as any hypersensitivity to textures which may result in refusal to eat. Hard textured foods, and formed solids that do not readily melt in the mouth, should be introduced much later and with discretion in order to reduce the risk of choking.

The above information was taken in part from materials posted on the American Academy of Pediatrics Website at http://www.aap.org

Farber, A.F., Yanni, C.C., & Batshaw, M.L. (1997). Nutrition: Good and bad. In M.L. Batshaw (Ed), Children with disabilities (pp. 197-198). Baltimore, MD: Paul Brookes Publishing.