Implementation of nutritional strategies decreases postnatal growth restriction in preterm infants

BACKGROUND: Prevention of postnatal growth restriction of very preterm infants still represents a challenge for neonatologists. As standard feeding regimens have proven to be inadequate. Improved feeding strategies are needed to promote growth. Aim of the present study was to evaluate whether a set of nutritional strategies could limit the postnatal growth restriction of a cohort of preterm infants. METHODOLOGY/PRINCIPAL FINDINGS: We performed a prospective non randomized interventional cohort study. Growth and body composition were assessed in 102 very low birth weight infants after the introduction of a set of nutritional practice changes. 69 very low birth weight infants who had received nutrition according to the standard nutritional feeding strategy served as a historical control group. Weight was assessed daily, length and head circumference weekly. Body composition at term corrected age was assessed using an air displacement plethysmography system. The cumulative parenteral energy and protein intakes during the first 7 days of life were higher in the intervention group than in the historical group (530\ub181 vs 300\ub193 kcal/kg, p<0.001 and 21\ub12.9 vs 15\ub13.2 g/kg, p<0.01). During weaning from parenteral nutrition, the intervention group received higher parental/enteral energy and protein intakes than the historical control group (1380\ub158 vs 1090\ub170 kcal/kg; 52.6\ub17 vs 42.3\ub110 g/kg, p<0.01). Enteral energy (kcal/kg/d) and protein (g/kg/d) intakes in the intervention group were higher than in the historical group (130\ub111 vs 100\ub113; 3.5\ub10.5 vs 2.2\ub10.6, p