Document Detail

Minimal enteral feeding within 3 d of birth in prematurely born infants with birth weight < or = 1200 g improves bone mass by term age.
MedLine Citation:
PMID:  16403735     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Evidence-based practice guidelines for aggressive nutritional intervention by using parenteral amino acids (AAs) and minimal enteral feeding (MEF) as early as the first day of life have not been tested for benefits to bone mass. OBJECTIVE: We investigated whether early introduction of parenteral AAs and MEF improves growth and bone mass achieved by term age in infants born prematurely. DESIGN: Twenty-seven infants who were < or = 1200 g and < or = 32 wk gestation at birth were randomly assigned by using a 2 x 2 design to treatment of either 1 g AAs/kg within the first 24 h or 12 mL MEF x kg(-1) x d(-1) within the first 72 h of life. Nutrition and growth were documented during hospitalization, and bone mineral content (BMC) of lumbar spine 1-4, femur, and whole body was measured at term age. Biomarkers of bone metabolism were measured at weeks 1, 3, and 5 and at discharge. Statistical analysis was conducted by using 2 x 2 analysis of variance for intent to treat and for infants receiving protocol nutrition. RESULTS: Over the first 14 d of life, a main effect of early AAs elevated total intake of protein, and a main effect of early MEF was a higher frequency of MEF volumes exceeding > 12 mL x kg(-1) x d(-1). Main effects on growth were not evident. An interaction effect was observed for osteocalcin whereby early AAs or MEF alone elevated osteocalcin. A main effect of early MEF yielded higher BMC of spine and femur. CONCLUSION: Early aggressive nutrition support with MEF enhances BMC in premature infants, but early MEF or AAs do not improve growth.
Hope A Weiler; Shirley C Fitzpatrick-Wong; Jeannine M Schellenberg; Denise E Fair; Ursula R McCloy; Rebecca R Veitch; Heather R Kovacs; Mary M Seshia
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  83     ISSN:  0002-9165     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-11     Completed Date:  2006-02-21     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  155-62     Citation Subset:  AIM; IM    
Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada.
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MeSH Terms
Absorptiometry, Photon
Amino Acids / administration & dosage*,  therapeutic use
Analysis of Variance
Bone Density / drug effects*
Bone Development / drug effects,  physiology
Enteral Nutrition*
Gestational Age
Growth / drug effects
Infant Nutritional Physiological Phenomena
Infant, Newborn
Infant, Premature / growth & development,  physiology*
Infant, Very Low Birth Weight / growth & development,  physiology*
Osteocalcin / blood
Parenteral Nutrition*
Reg. No./Substance:
0/Amino Acids; 104982-03-8/Osteocalcin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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