Document Detail

Feeding the low birth weight infant.
MedLine Citation:
PMID:  8458165     Owner:  NLM     Status:  MEDLINE    
A true gold standard for assessing the nutritional outcome of preterm infants remains elusive. We are seeing an expansion beyond the traditional intrauterine-based short-term growth and nutrient retention rates toward a broader, and possibly life-long, range of outcomes. As our nutritional end points shift, the suitability of the preterm infants' own mothers' milk may become more apparent. Whether the unique properties of human milk or the use of human milk components for fortification are sufficient to rekindle the use of donor milk from milk banks remains to be seen. Improved formulas designed specifically for preterm infants and the possibility of providing passive immunity in formula have added fuel to the debate over what constitutes an ideal nutrient source. The optimal time to begin to feed our smallest and sickest patients is being reevaluated. A policy of exclusive parenteral nutrition for prolonged periods of time may be replaced with one in which minimal amounts of feeding are used, in conjunction with parenteral support, to prepare and maintain intestinal function until advancements toward full enteral nutrition are possible. Although well-controlled trials are needed to add substance to our decisions on many feeding methods, such as intermittent bolus versus continuous gastric infusion, the use of transpyloric feeding should be discouraged. Finally, we need to determine if there are any tangible nutritional benefits from the use of nonnutritive sucking. It is hoped that resolution of some of the controversies of feeding preterm infants will broaden our clinical view of infant nutrition. The discussion on work rounds will then move away from the current "did the baby get 120 kcal/kg yesterday?" toward an informed discussion of how, what, when, and why to feed the infant. Over a century ago, Abraham Jacopi cautioned pediatricians that "You cannot feed a baby with mathematics; you must feed them with brains."
S J Gross; T A Slagle
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinics in perinatology     Volume:  20     ISSN:  0095-5108     ISO Abbreviation:  Clin Perinatol     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-04-28     Completed Date:  1993-04-28     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7501306     Medline TA:  Clin Perinatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  193-209     Citation Subset:  IM    
Division of Neonatology, SUNY Health Science Center, Syracuse.
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MeSH Terms
Enteral Nutrition
Infant Food
Infant Nutritional Physiological Phenomena*
Infant, Low Birth Weight*
Infant, Newborn
Milk, Human

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