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
27 - Fortified human milk for premature infants
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
Introduction
Nutrition support of the premature infant must be designed to compensate for metabolic and gastrointestinal immaturity, immunologic compromise, and associated medical conditions. Nutritional needs are determined based on intrauterine rates of growth and nutrient accretion. The beneficial effects of human milk extend to the feeding of premature infants (Chapter 26). Human milk is capable of satisfying most of the needs of premature infants if careful attention is given to nutritional status. Nevertheless, because of their specialized needs the human milk-fed premature infant may require nutrient supplementation, or fortification, to maintain optimal nutritional status while deriving benefits from enhanced host defense, neurologic development, and gastrointestinal function. The nutritional adequacy of human milk for premature infants may be limited for several reasons. The nutrient content of the milk may be inadequate for their needs and the variability in nutrient content results in an unpredictable nutrient intake for an infant who cannot feed ad libitum. Infants often receive restricted milk intakes. Mothers often are unable to supply sufficient milk to meet the needs of the infant throughout the hospitalization. As a consequence, nutrient inadequacy may manifest in the premature infant fed unfortified human milk. This review will focus on the feeding of fortified human milk to the premature infant.
Composition of preterm milk
Milk from mothers who give birth prematurely (preterm milk) generally has greater concentrations of immune proteins, lipid, energy, vitamins, calcium, sodium, and trace elements than in corresponding term milk.
- Type
- Chapter
- Information
- Neonatal Nutrition and Metabolism , pp. 401 - 408Publisher: Cambridge University PressPrint publication year: 2006
References
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