Feeding The Littlest Preemies: Growth, Health And A Full Tummy

October 5, 2011


Thanks to 30 years of study at the Children's Nutritional Research Center in collaboration with the USDA, Agricultural Research Service, Baylor College of Medicine and Texas Children's Hospital, we know more than ever about babies' dietary needs. You may have heard the buzz recently about our transition to a breast-milk-only NICU.

We also recently got some nice editorial comments about a study we did involving some of the NICU's most vulnerable preemies who have a condition called bronchopulmonary dysplasia (BPD).

BPD is a common side effect of preterm birth, especially among

the smallest and earliest of infants.

Since babies with BPD are swimming in excess lung fluid, it can be important to place them on a fluid-restricted diet. However, equally important in such small babies is building up their bone strength and lung capacity with calcium and other minerals, especially given the high prevalence of rickets and other disorders of mineral-deficiency in very premature babies.

One way to deliver the needed nutrients in a fluid-restricted diet is to fortify the milk, so that even smaller volumes of feedings constitute a nutritional powerhouse.

Since very few studies had been done on the effects of nutrition in infants on restricted diets in the NICU, we looked at calcium metabolism and bone mineral status in infants on various fluid-restricted diets and evaluated their growth and body composition on various feeding regimens (breast milk or preterm formula enhanced with either cow milk- or breast milk-based fortifiers).

We found that babies on such diets grew well, regardless of which type of feeding was chosen, achieving almost the same bone growth outcomes as they would have had even if they had not been born so early. In short, we encourage NICUs to do whatever necessary to feed these infants the caloric (especially protein!) and bone mineral levels they need while maintaining the appropriate fluid restrictions. Given the appropriate care, these infants can absorb and use nutrients as well as any baby, which is everyone's ultimate goal.

In commenting on our article, the editorial writer in the Journal of Pediatrics commented that "this study paints a picture of a neonatal intensive care unity where attention to nutrition is paying off."

Calcium Absorption in Very Low Birth Weight Infants with and without Bronchopulmonary Dysplasia

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