Programming Long-Term Health: Nutritional and Dietary Needs in Infant Prematurity

Poor nutrition and impaired growth of premature infants is associated with adverse consequences in the long term. The overall goal of feeding preterm infants is to mimic intrauterine growth pattern and, as importantly, to obtain a body composition and achieve a functional outcome comparable to term born infants. Over the last decades knowledge on nutrition of preterm infants has accumulated and clinical guidelines on nutritional requirements have been regularly revised. Nevertheless, extrauterine growth restriction is still the rule rather than the exception in preterm infants and is associated with impaired neurocognitive development later in life. Postnatal growth restriction has multifactorial causes, but it has been estimated that about 50% of the variance in early postnatal growth restriction can be attributed to nutrition. In a large proportion of the premature infants the actual dietary intake does not meet the recommended intake during the first weeks of life, while this takes time to establish. Additionally, adequate growth is best achieved with optimal enteral nutrition, but bringing the intestine of a prematurely born infant in a condition that allows administration of sufficient amounts of nutrients takes a while. Once the recommended dietary intake is established it rarely can be maintained during the entire hospital stay due to the possible appearance of complications related to prematurity, such as sepsis, necrotizing enterocolitis or chronic lung disease, which increases the nutrient deficit.