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Nutrition of late preterms

Christina J Valentine, Georgia Morrow, Amanda Reisinger, Kelly A Dingess, Ardythe L Morrow, Lynette K Rogers
BACKGROUND: Mother's own milk is the first choice for feeding preterm infants, but when not available, pasteurized human donor milk (PDM) is often used. Infants fed PDM have difficulties maintaining appropriate growth velocities. To assess the most basic elements of nutrition, we tested the hypotheses that fatty acid and amino acid composition of PDM is highly variable and standard pooling practices attenuate variability; however, total nutrients may be limiting without supplementation due to late lactational stage of the milk...
March 18, 2017: Nutrients
Haerani Rasyid, Syakib Bakri
Low birth weight (LBW) is defined as a birth weight of a liveborn infant of <2,500 gram. In developed countries, LBW is commonly caused by preterm birth; while in developing countries, it is mostly due to intrauterine growth retardation. The concept of developmental origins of adult diseases, particularly on late-onset diseases such as hypertension and kidney disease, implies that there is a correlation between intrauterine milieu, intrauterine growth retardation, premature birth and infant feeding. The 'fetal origin hypothesis' suggests that metabolic diseases are directly related to poor nutritional status in early life...
October 2016: Acta Medica Indonesiana
Odile Dicky, Virginie Ehlinger, Nathalie Montjaux, Gisèle Gremmo-Féger, Jacques Sizun, Jean-Christophe Rozé, Catherine Arnaud, Charlotte Casper
AIM: Since 2005, the French Food Safety Agency has recommended that very preterm or low-birthweight babies should be fed with pasteurised, expressed breastmilk, and feeding policies on this vary widely in French neonatal units. We investigated the differences between using a mother's expressed milk, in fresh or pasteurised forms, for very preterm infants. METHODS: This observational multicentre study analysed data on 926 very preterm infants: 636 from neonatal units who used the mother's own fresh milk and 290 who used the mother's milk after pasteurisation...
January 27, 2017: Acta Paediatrica
Naomi M Saville, Bhim P Shrestha, Sarah Style, Helen Harris-Fry, B James Beard, Aman Sengupta, Sonali Jha, Anjana Rai, Vikas Paudel, Anni-Maria Pulkki-Brannstrom, Andrew Copas, Jolene Skordis-Worrall, Bishnu Bhandari, Rishi Neupane, Joanna Morrison, Lu Gram, Raghbendra Sah, Machhindra Basnet, Jayne Harthan, Dharma S Manandhar, David Osrin, Anthony Costello
BACKGROUND: Low birth weight (LBW, < 2500 g) affects one third of newborn infants in rural south Asia and compromises child survival, infant growth, educational performance and economic prospects. We aimed to assess the impact on birth weight and weight-for-age Z-score in children aged 0-16 months of a nutrition Participatory Learning and Action behaviour change strategy (PLA) for pregnant women through women's groups, with or without unconditional transfers of food or cash to pregnant women in two districts of southern Nepal...
October 21, 2016: BMC Pregnancy and Childbirth
Peymaneh Alizadeh Taheri, Negar Sajjadian, Marzieh Asgharyan Fargi, Mamak Shariat
OBJECTIVE: Breast feeding alone does not provide adequate nutrition for growth in preterm infants; therefore, fortifiers are added when over 70-80 cc/kg/day of breast milk is tolerated. As there are few studies comparing early and late breast milk fortification, the following study was conducted. STUDY DESIGN: This double-blind clinical trial was performed on 80 preterm infants (gestational age of 28-34 weeks, birth weight <2 kg). The newborns were randomly divided into two groups to receive either early or late fortification...
September 27, 2016: Journal of Perinatal Medicine
Baiba Steinbrekera, Robert Roghair
The risk of hypertension is increased by intrauterine growth restriction (IUGR) and preterm birth. In the search for modifiable etiologies for this life-threatening cardiovascular morbidity, a number of pathways have been investigated, including excessive glucocorticoid exposure, nutritional deficiency and aberration in sex hormone levels. As a neurotrophic hormone that is intimately involved in the cardiovascular regulation and whose levels are influenced by glucocorticoids, nutritional status and sex hormones, leptin has emerged as a putative etiologic and thus a therapeutic agent...
November 2016: Journal of Endocrinology
Anndrea Flint, Karen New, Mark W Davies
BACKGROUND: Breast milk provides optimal nutrition for term and preterm infants, and the ideal way for infants to receive breast milk is through suckling at the breast. Unfortunately, this may not always be possible for medical or physiological reasons such as being born sick or preterm and as a result requiring supplemental feeding. Currently, there are various ways in which infants can receive supplemental feeds. Traditionally in neonatal and maternity units, bottles and nasogastric tubes have been used; however, cup feeding is becoming increasingly popular as a means of offering supplemental feeds in an attempt to improve breastfeeding rates...
August 31, 2016: Cochrane Database of Systematic Reviews
Jemma S Cleminson, Stefan P Zalewski, Nicholas D Embleton
PURPOSE OF REVIEW: The increasing recognition of the role of nutritional care for preterm infants continues to result in a proliferation of review articles, systematic reviews, observational studies and trials. In this article, we review a selection of important studies published in the last 12–18 months. RECENT FINDINGS: The selected studies demonstrate the potential importance of light protecting parenteral nutrition solutions, the benefits of standardized concentrated parenteral nutrition solutions and the importance of insulin-like growth factor I in early life...
May 2016: Current Opinion in Clinical Nutrition and Metabolic Care
T Thymann
After birth, the newborn must adapt to the acute challenges of circulatory changes, active respiration, thermoregulation, microbial colonization, and enteral nutrition. Whereas these processes normally occur without clinical complications in neonates born at term, birth at a preterm state of gestation is associated with high morbidity and mortality. In commercial pig production, perinatal mortality is higher than in any other mammalian species. Asphyxia, hypothermia, hypoglycemia, sepsis, and gut dysmotility, represent some of the most common findings...
July 2016: Domestic Animal Endocrinology
Hideaki Yagasaki, Yasushi Murakami, Tetsuo Ohyama, Keiichi Koizumi, Minako Hoshiai, Takaya Nakane, Kanji Sugita
OBJECTIVE: Moderately preterm (MP) (32-33 weeks) and late preterm (LP) (34-36 weeks) infants have higher risks of mortality and growth and developmental problems. We, herein present a new concept of nutritional assessment, total energy intake (TEI), which is the sum total of kilocalories administered in all nutrient forms. METHODS: Fifty-two preterm infants were classified as MP (n = 12), LP/appropriate for gestational age (LP/AGA) (n = 33), or LP/small for gestational age (LP/SGA) (n = 7)...
July 4, 2016: Journal of Maternal-fetal & Neonatal Medicine
Lopes Anne-Aurélie, Belhabri Souad, Karaoui Leila
Background Nonpasteurized, nonfrozen, fresh breast milk from mothers with positive cytomegalovirus (CMV) serology was initially contraindicated to very low-birth-weight infants because of the risk of milk-acquired CMV infection. Recently, the severity of this infection was increasingly discussed and the international guidelines now differ. Since 2012, the American Academy of Pediatrics has recommended nutrition through raw breast milk for all preterm infants. Case We report the case of an infant born prematurely at 27 weeks and 4 days and fed with raw breastmilk from day 12 of life (D12)...
April 2016: American Journal of Perinatology Reports
Rowena Cayabyab, Rangasamy Ramanathan
Retinopathy of prematurity (ROP) continues to be a major preventable cause of blindness and visual handicaps globally. With improved perinatal care, improved survival of moderately preterm infants, and limited resources for oxygen delivery and monitoring, more mature preterm infants are developing severe ROP in developing countries. The pathophysiology of ROP is characterized by two phases. Phase I ROP is due to vaso-obliteration beginning immediately after birth secondary to a marked decrease in vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1)...
2016: Neonatology
Montserrat Izquierdo, Antonio Federico Martínez-Monseny, Neus Pociello, Paloma Gonzalez, Ruth Del Rio, Martin Iriondo, Isabel Iglesias-Platas
BACKGROUND AND AIMS: Postnatal growth restriction remains a serious problem in very low-birth-weight infants. Enhanced parenteral supply of nutrients as soon as possible after birth is one of the strategies addressed to avoid extrauterine growth restriction. We aimed to analyze changes in growth patterns and in clinical outcomes in our unit after a change in our parenteral nutrition (PN) protocol. METHODS: We collected data from 2 time periods, comprising the 2 years before (period I) and the 2 years after (period II) the change of protocol...
October 2016: Nutrition in Clinical Practice
Sunit C Singhi, Suresh Kumar
Gut microflora contribute greatly to immune and nutritive functions and act as a physical barrier against pathogenic organisms across the gut mucosa. Critical illness disrupts the balance between host and gut microflora, facilitating colonization, overgrowth, and translocation of pathogens and microbial products across intestinal mucosal barrier and causing systemic inflammatory response syndrome and sepsis. Commonly used probiotics, which have been developed from organisms that form gut microbiota, singly or in combination, can restore gut microflora and offer the benefits similar to those offered by normal gut flora, namely immune enhancement, improved barrier function of the gastrointestinal tract (GIT), and prevention of bacterial translocation...
2016: F1000Research
Claudia Correia, Gustavo Rocha, Filipa Flor-DE-Lima, Hercília Guimarães
BACKGROUND: Late preterm delivery (74% of all preterm births) increases the incidence of respiratory pathology, namely respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN) and the need of ventilator support when compared to term delivery. The aim is to evaluate the respiratory morbimortality in late preterm infants and the risk factors associated with RDS and TTN. METHODS: Descriptive retrospective study of all newborns of 34+0 to 36+6 weeks of gestational age, born at our centre between September 1, 2012 and August 31, 2015...
April 14, 2016: Minerva Pediatrica
Walter A Mihatsch, Christian Braegger, Jiri Bronsky, Cristina Campoy, Magnus Domellöf, Mary Fewtrell, Nataša F Mis, Iva Hojsak, Jessie Hulst, Flavia Indrio, Alexandre Lapillonne, Christian Mlgaard, Nicholas Embleton, Johannes van Goudoever
Vitamin K deficiency bleeding (VKDB) due to physiologically low vitamin K plasma concentrations is a serious risk for newborn and young infants and can be largely prevented by adequate vitamin K supplementation. The aim of this position paper is to define the condition, describe the prevalence, discuss current prophylaxis practices and outcomes, and to provide recommendations for the prevention of VKDB in healthy term newborns and infants. All newborn infants should receive vitamin K prophylaxis and the date, dose, and mode of administration should be documented...
July 2016: Journal of Pediatric Gastroenterology and Nutrition
M D Akkermans, L Uijterschout, M Abbink, P Vos, L Rövekamp-Abels, B Boersma, J B van Goudoever, F Brus
BACKGROUND/OBJECTIVES: Late preterm infants (born ⩾32 weeks of gestation) are at risk for developing iron deficiency and iron deficiency anaemia, and this may lead to impaired neurodevelopment. In the Netherlands, there is no guideline for standardised iron supplementation in these infants. Individualised iron supplementation has been suggested (that is, treating those infants with the highest risk), but risk factors for deprived iron stores in this specific group of infants are not well documented...
August 2016: European Journal of Clinical Nutrition
Adriana Martins de Lima, Ana Lucia Goulart, Adriana Bruscato Bortoluzzo, Benjamin Israel Kopelman
OBJECTIVE: to assess the nutritional practices in neonatal intensive care units (NICU) associated with growth retardation in premature (preterm) infants. METHODS: retrospective study of preterm infants weighing between 500 and 1,499 g admitted to NICU. Evolution of growth and parenteral (PN) and enteral (EN) nutrition practices were analyzed. RESULTS: among 184 preterm infants divided into G1 (500 to 990 g; n=63) and G2 (1000 to 1499 g; n=121), 169 received PN (G1=63, G2=106)...
November 2015: Revista da Associação Médica Brasileira
Brietta M Oaks, Kevin D Laugero, Christine P Stewart, Seth Adu-Afarwuah, Anna Lartey, Per Ashorn, Stephen A Vosti, Kathryn G Dewey
BACKGROUND: High circulating cortisol is associated with miscarriage, preterm birth, and low birth weight. Research in nonpregnant individuals suggests that improved nutrition may lower cortisol concentrations. It is unknown whether nutritional supplementation during pregnancy lowers cortisol. OBJECTIVE: Our objective was to determine whether women receiving a lipid-based nutrient supplement (LNS) throughout pregnancy would have lower salivary cortisol at 36 wk gestation compared with women receiving other nutrient supplements...
February 2016: Journal of Nutrition
Maria Lorella Giannì, Paola Roggero, Pasqua Piemontese, Nadia Liotto, Anna Orsi, Orsola Amato, Francesca Taroni, Laura Morlacchi, Dario Consonni, Fabio Mosca
BACKGROUND: Late preterm birth accounts for 70 % of all preterm births. While the impact of feeding problems in very preterm infants has been widely investigated, data on late preterm infants' feeding issues are scarce. The aim of the present study was to investigate the need of nutritional support during hospital stay in a cohort of late preterm infants and to identify the factors that most contribute to its occurrence. METHODS: We analyzed the medical records of late preterm infants, born 2011-2013, admitted to a single institution...
November 23, 2015: BMC Pediatrics
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