The Turkish Journal of Pediatrics
2013 , Vol 55 , Num 4
Short- and Long-Term Effects of Individualized Enteral Protein Supplementation in Preterm Newborns
Divisions of 1Neonatology, and 3Pediatric Neurology, 2Department of Pediatrics, Gazi University Faculty of Medicine,
Ankara, Turkey. E-mail: ebruergenekon@gmail.com
The aim of this retrospective study was to assess the need for additional
enteral protein supplementation in preterm newborns with gestational age
(GA) ≤32 weeks after full enteral feeds with either fortified breast milk
(FBM) or preterm formula (PF) were reached, and to determine the effects
of additional protein on physical and neurological development. After the
standard early total parenteral nutrition (TPN) and reaching full enteral
nutrition with 150-160 ml/kg/day, preterms were assessed for the requirement
of additional protein based on serum blood urea nitrogen (BUN)/prealbumin
levels. Additional enteral protein was given for BUN <5 mg/dl and/or
prealbumin ≤8 mg/dl with weekly assessments as per Neonatal Intensive
Care Unit (NICU) protocol. Growth in the NICU and neurodevelopmental
outcome at 18 months’ corrected age (CA) were determined.
There were 32 newborns in the non-supplemented group (Group 1) and 33 newborns in the supplemented group (Group 2). All newborns in Group 2 were on FBM. Weight gain and head growth were better and Bayley scores at 18 months’ CA were higher in Group 2.
Standard preterm nutrition with FBM may not be sufficient for preterms, and additional enteral protein supplementation may improve the physical growth rate in the NICU and result in better neurodevelopmental outcome at 18 months’ CA.
Keywords : preterm newborn, enteral protein, growth, neurodevelopmental outcome.