Nutrition of preterm infants

1
Nutrition of preterm infants

• Until WW II, breast milk was used for all preterm
  infants
• Since 1947, after the study by Gordon et al, two
  different strategies have been established
• Formula, now preterm formula
• Breast milk, now usually fortified

2
Breast milk vs. formula

• Formula
• Nutritional advantages
• Composition known, no variation
• Nonnutritional advantages
• ?

3
Breast milk vs. formula

• Breast milk
• Nutritional advantages
• Species-specific proteins
• Fat digestion facilitated - fat globule, lipase
  activity
• Carbohydrates - oligosaccharides, lactose -
  stool consistency
• High bioavailability of Zn, Fe etc

4
Breast milk vs. formula

• Breast milk
• Nonnutritional advantages
• Improved cognitive and visual function
• Enhanced gastrointestinal maturity and
  tolerance
• Antiinfective properties - less septicemia
• Less NEC, ROP
• Faster full enteral feeding
• Shorter duration of hospitalization

5
Breast milk vs. formula

• Schanler RJ, Hurst NM, Lau C. The use of human
  milk and breastfeeding in premature infants
• Clin Perinatol 199926379
• Schanler RJ. The use of human milk for
  premature infants
• Pediatr Clin N Am 200148207

6
Breast milk vs. formula

• Research is now suggesting that human milk may
  be even more important for compromised and
  preterm infants than for full-term infants
• Wight NE. Breastmilk Its not just for
  breakfast anymore!
• J Perinatol 200121349