Protein and Preterm Infants

Protein is a major driving force for growth and, therefore, long-term outcome.¹

— 2014 Global Expert Recommendations

The nutritional goal for preterm infants is to achieve a postnatal growth rate, tissue composition, and functional outcome that is as close as possible to that of a normal fetus at the same postmenstrual age.¹

• To achieve this, it is important to have an adequate balance of energy to protein in the preterm diet. Both energy and protein are important to promote growth.¹

Neonatal nutrition experts have increased the level of protein they recommend to promote postnatal growth and long term outcomes^1-3

Increased protein intake improved linear growth status⁴

For example, the difference in a length z-score change of +0.77 for an infant boy 36 0/7 weeks’ postmenstrual age (PMA)⁴

• Stoll et al reported that 79% of extreme preterm infants are below the 10th percentile by 36 weeks’ PMA⁵
• Data from Olsen et al 2014 suggest an additional 100 grams of protein over 28 days could significantly improve length z-score⁴

Linear growth in premature infants is an important factor in neurological development^6,7

^* Study did not specify brand or product type fed to infants

BSID=Bayley Scales of Infant Development; CA=corrected age; SD=standard deviation; VLBW=very low birth weight

Increased protein intake in first week improved neurodevelopmental outcomes in ELBW infants⁸

^* Included parenteral and enteral protein intake

CA=corrected age; ELBW=extremely low birth weight; MDI=Mental Development Index

References: 1. Koletzko B et al. Nutritional Care of Preterm Infants: Scientific Basis and Practical Guidelines. Basel, Switzerland: Karger; 2014; 1-314. 2. Tsang RC et al. eds. Nutritional of the Preterm Infant: Scientific Basis and Practical Guidelines. 2nd ed. Cincinnati, OH: Digital Educational Publishing, Inc. 2005. 3. Tsang RC et al. eds. Nutritional Needs of the Preterm Infant: Scientific Basis and Practical Guidelines. Pawling, NY: Caduceus Medical Publishers, Inc. 1993. 4. Olsen IE et al. J Pediatr Gastroenterol Nutr. 2014; 58:409-416. 5. Stoll BJ et al. Pediatrics. 2010; 126:443-456. 6. Pfister KM et al. Pediatr Res. 2013; 74:576-583. 7. Ramel SE et al. Neonatology. 2012; 102:19-24. 8. Stephens BE et al. Pediatrics. 2009; 123:1337-1343.