Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- List of abbreviations
- 1 Fetal nutrition
- 2 Determinants of intrauterine growth
- 3 Aspects of fetoplacental nutrition in intrauterine growth restriction and macrosomia
- 4 Postnatal growth in preterm infants
- 5 Thermal regulation and effects on nutrient substrate metabolism
- 6 Development and physiology of the gastrointestinal tract
- 7 Metabolic programming as a consequence of the nutritional environment during fetal and the immediate postnatal periods
- 8 Nutrient regulation in brain development: glucose and alternate fuels
- 9 Water and electrolyte balance in newborn infants
- 10 Amino acid metabolism and protein accretion
- 11 Carbohydrate metabolism and glycogen accretion
- 12 Energy requirements and protein-energy metabolism and balance in preterm and term infants
- 13 The role of essential fatty acids in development
- 14 Vitamins
- 15 Normal bone and mineral physiology and metabolism
- 16 Disorders of mineral, vitamin D and bone homeostasis
- 17 Trace minerals
- 18 Iron
- 19 Conditionally essential nutrients: choline, inositol, taurine, arginine, glutamine and nucleotides
- 20 Intravenous feeding
- 21 Enteral amino acid and protein digestion, absorption, and metabolism
- 22 Enteral carbohydrate assimilation
- 23 Enteral lipid digestion and absorption
- 24 Minimal enteral nutrition
- 25 Milk secretion and composition
- 26 Rationale for breastfeeding
- 27 Fortified human milk for premature infants
- 28 Formulas for preterm and term infants
- 29 Differences between metabolism and feeding of preterm and term infants
- 30 Gastrointestinal reflux
- 31 Hypo- and hyperglycemia and other carbohydrate metabolism disorders
- 32 The infant of the diabetic mother
- 33 Neonatal necrotizing enterocolitis: clinical observations and pathophysiology
- 34 Neonatal short bowel syndrome
- 35 Acute respiratory failure
- 36 Nutrition for premature infants with bronchopulmonary dysplasia
- 37 Nutrition in infants with congenital heart disease
- 38 Nutrition therapies for inborn errors of metabolism
- 39 Nutrition in the neonatal surgical patient
- 40 Nutritional assessment of the neonate
- 41 Methods of measuring body composition
- 42 Methods of measuring energy balance: calorimetry and doubly labelled water
- 43 Methods of measuring nutrient substrate utilization using stable isotopes
- 44 Postnatal nutritional influences on subsequent health
- 45 Growth outcomes of preterm and very low birth weight infants
- 46 Post-hospital nutrition of the preterm infant
- Index
- References
46 - Post-hospital nutrition of the preterm infant
Published online by Cambridge University Press: 10 December 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- List of abbreviations
- 1 Fetal nutrition
- 2 Determinants of intrauterine growth
- 3 Aspects of fetoplacental nutrition in intrauterine growth restriction and macrosomia
- 4 Postnatal growth in preterm infants
- 5 Thermal regulation and effects on nutrient substrate metabolism
- 6 Development and physiology of the gastrointestinal tract
- 7 Metabolic programming as a consequence of the nutritional environment during fetal and the immediate postnatal periods
- 8 Nutrient regulation in brain development: glucose and alternate fuels
- 9 Water and electrolyte balance in newborn infants
- 10 Amino acid metabolism and protein accretion
- 11 Carbohydrate metabolism and glycogen accretion
- 12 Energy requirements and protein-energy metabolism and balance in preterm and term infants
- 13 The role of essential fatty acids in development
- 14 Vitamins
- 15 Normal bone and mineral physiology and metabolism
- 16 Disorders of mineral, vitamin D and bone homeostasis
- 17 Trace minerals
- 18 Iron
- 19 Conditionally essential nutrients: choline, inositol, taurine, arginine, glutamine and nucleotides
- 20 Intravenous feeding
- 21 Enteral amino acid and protein digestion, absorption, and metabolism
- 22 Enteral carbohydrate assimilation
- 23 Enteral lipid digestion and absorption
- 24 Minimal enteral nutrition
- 25 Milk secretion and composition
- 26 Rationale for breastfeeding
- 27 Fortified human milk for premature infants
- 28 Formulas for preterm and term infants
- 29 Differences between metabolism and feeding of preterm and term infants
- 30 Gastrointestinal reflux
- 31 Hypo- and hyperglycemia and other carbohydrate metabolism disorders
- 32 The infant of the diabetic mother
- 33 Neonatal necrotizing enterocolitis: clinical observations and pathophysiology
- 34 Neonatal short bowel syndrome
- 35 Acute respiratory failure
- 36 Nutrition for premature infants with bronchopulmonary dysplasia
- 37 Nutrition in infants with congenital heart disease
- 38 Nutrition therapies for inborn errors of metabolism
- 39 Nutrition in the neonatal surgical patient
- 40 Nutritional assessment of the neonate
- 41 Methods of measuring body composition
- 42 Methods of measuring energy balance: calorimetry and doubly labelled water
- 43 Methods of measuring nutrient substrate utilization using stable isotopes
- 44 Postnatal nutritional influences on subsequent health
- 45 Growth outcomes of preterm and very low birth weight infants
- 46 Post-hospital nutrition of the preterm infant
- Index
- References
Summary
Post-hospital nutrition of the preterm infant
Precise nutrient requirements and achievable growth remain to be defined for the premature infant post-hospital discharge. While fetal growth serves as the standard for the infant less than 37 weeks gestation and breastfeeding meets the needs of the healthy term infant, neither goal meets the needs of the premie graduate. The graduate of the newborn intensive care unit (NICU) frequently enters into the home setting at a physical size which is significantly less than that of the fetus of the same postmenstrual age. Nutrient need may be further altered by gender, ethnicity, hospital course and post hospital clinical status.
The limited number of investigations on nutrition post-hospital discharge differ in their infant population, study diet, duration of study diet, and final results. Post discharge formulas have recently been developed and may meet the nutrient demands for selected premature infants. Continued monitoring of the infant's dietary intake, anthropometric measurements, and clinical status will help to determine if the infant's needs are met or if nutrient supplementation is indicated.
Growth
Premature infants can grow at the fetal growth rate of at least 15 g kg−1day−1 in the NICU. This rate results in growth that parallels fetal growth, but because adequate weight gain commences only after 1–2 weeks it does not result in catch-up growth during the hospital stay. Although most premature infants begin life appropriately grown, they are frequently discharged at a weight less than the 10th percentile for age.
- Type
- Chapter
- Information
- Neonatal Nutrition and Metabolism , pp. 654 - 662Publisher: Cambridge University PressPrint publication year: 2006