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United States Department of Agriculture

Agricultural Research Service

Title: Clinical Experience in Enteral Nutrition Support for Premature Infants Withbronchopulmonary Dysplasia

Authors
item Puangco, Maria - BAYLOR COLLEGE MED
item Schanler, Richard

Submitted to: Journal of Perinatology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: October 15, 2000
Publication Date: N/A

Interpretive Summary: Babies who are born prematurely often have special problems due to the fact that they did not have the usual nine months' time to fully develop inside the mother. Some babies suffer from bronchopulmonary dysplasia (BPD), relating to abnormal lung development. The nutritional management of these babies presents the doctor with a complex challenge. That is because such babies require greater energy and protein intakes to increase their growth but diuretic therapy and fluid restriction to treat the BPD can pose feeding conflicts compromising their growth. We evaluated two types of formulas given to 27 premature infants with BPD who were severely fluid- restricted. We examined the babies' growth, their feeding tolerance and the potential for nutrient inadequacies. They were fed either a 30 kcal/oz ready-to-feed formula or a preterm formula with a variety of nutrient supplements. We found the 30 kcal/oz ready-to-feed formula was well tolerated. This formula provided a nutrient composition similar to preterm formula enhanced with additives, but improved protein nutritional status. Growth and feeding tolerance were similar. We found this ready-to-feed formula to be a safe alternative to preterm formula containing multiple additives, when provided to preterm babies with BPD. These new study findings will be very helpful to doctors who treat babies with this challenging condition, as they want to increase these babies' growth both rapidly and safely via optimal forms of nutrition.

Technical Abstract: Objectives: The comprehensive management of infants with bronchopulmonary dysplasia (BPD) may include the need for fluid restriction. Modular nutrient components added to preterm formulas increase energy and protein contents but may compromise the nutrient integrity of the formula. The purpose of this pilot study was to compare the nutritional status and feeding tolerance of infants fed either a 30 kcal/oz ready-to-feed formula or a preterm formula containing nutrient supplements. Methods: Feeding tolerance, growth, and biochemical indicators of nutritional status were compared in 27 premature infants with BPD who were fluid restricted. They were fed either a 30 kcal/oz ready-to-feed formula or preterm formula with additives concentrated to 30 kcal/oz. Results: Growth and feeding tolerance were similar between groups. Serum albumin and blood urea nitrogen concentrations, however, were improved in the ready-to-feed formula group. Conclusion: A 30 kcal/oz ready-to-feed formula provides similar nutrient composition, but improved protein nutritional status, and is a safe alternative to preterm formula containing multiple nutrient additives in premature infants with BPD.

Last Modified: 4/19/2014
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