Protein Intakes during Weaning from Parenteral Nutrition Drive Growth Gain and Body Composition in Very Low Birth Weight Preterm Infants

Nadia Liotto, Orsola Amato, Pasqua Piemontese, Camilla Menis, Anna Orsi, Maria Grazia Corti, Mariarosa Colnaghi, Valeria Cecchetti, Lorenza Pugni, Fabio Mosca, Paola Roggero

Research output: Contribution to journalArticlepeer-review

Abstract

Weaning from parenteral to enteral nutrition is a critical period to maintain an adequate growth in very low birth weight preterm infants (VLBWI). We evaluated the actual daily nutritional intakes during the transition phase (TP) in VLBWI with adequate and inadequate weight growth velocity (GV ≥ 15 vs. GV < 15 g/kg/day). Fat-free mass (FFM) at term-corrected age (TCA) was compared between groups. Based on actual nutritional intakes of infants with adequate growth, we defined a standardized parenteral nutrition bag (SPB) for the TP. One hundred and six VLBWI were categorized as group 1 (G1): [GV < 15 (n = 56)] and group 2 (G2): [GV ≥ 15 (n = 50)]. The TP was divided into two periods: main parenteral nutritional intakes period (parenteral nutritional intakes >50%) (M-PNI) and main enteral nutritional intakes period (enteral nutritional intakes >50%) (M-ENI). Anthropometric measurements were assessed at discharge and TCA, FFM deposition at TCA. During M-PNI, G2 showed higher enteral protein intake compared to G1 (p = 0.05). During M-ENI, G2 showed higher parenteral protein (p = 0.01) and energy intakes (p < 0.001). A gradual reduction in SPB volume, together with progressive increase in enteral volume, allowed nutritional intakes similar to those of G2. At TCA, G2 had higher FFM compared to G1 (p = 0.04). The reasoned use of SPB could guarantee an adequate protein administration, allowing an adequate growth and higher FFM deposition.

Original languageEnglish
Article number1298
JournalNutrients
Volume12
Issue number5
DOIs
Publication statusPublished - May 2 2020

Keywords

  • body composition
  • growth velocity
  • parenteral nutrition weaning
  • preterm infants
  • standardized parenteral nutrition bag
  • very low birth weight

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

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