Babies with very low birth weight normally catch up
with the growth of other babies of the same age. This is sometimes not achieved
due to inadequate nutrition and could affect the brain development of the
child. Supplements may help to improve the growth; unfortunately they also
result in an increase in fat.
The goal of
nutrition in babies with very low birth weight should be to maintain growth and
prevent complications without any adverse effects of the supplementation
A study was conducted to evaluate if a high protein
and high energy supplement would improve the weight and lean body mass in
preterm infants and if such supplementation would be well tolerated by the
Thirty-eight preterm infants from Spain at less than
32 weeks gestation and with weights of less than 1500g were included in the
study. The newborns were free from complications and were gaining weight. These
babies were divided according to the types of supplements they received. Group
A received the standard preterm formula. Group B and C received high energy and
protein formulation; the protein content of the formulation given to group C
was higher than that given to group B.
The weight, length and head circumference of the
infants were measured weekly for 4 weeks to monitor their growth. Using the
weight and length measurements, the body mass index was calculated. Body
composition was measured using total body electrical impedance analysis. Fat
mass and fat-free mass were calculated on the last day of the study.
The high energy and protein supplements were well
tolerated by the groups B and C. At the
end of the study, the weight gain in these groups was more than that in group
A, with an increase in fat-free mass. The head circumference was more in group
B as compared with group A
. An increase in head circumference indicates a
better growth of the brain.
Protein intake was higher in group C than in group
B; however there were no differences in weight gain or fat-free mass between these
two groups. Thus an intake of 150 kcal/kg/d of energy and 4.2 g/kg/d of
protein, with a protein/energy ratio of 2.8 g/100 kcal, similar to that of
group B is usually enough to increase the weight of very low birth weight
infants. Urea levels were increased in the groups taking protein
supplementation, but to insignificant levels.
The study thus indicates
that formulations with high energy and protein help to increase weight and
fat-free mass in babies with very low birth weight as compared to those on
usual formulations for preterm infants
. In order to achieve the higher concentrations of
energy and proteins, the usual formulations could be enriched with supplements,
or their volume or concentration may be increased.
1. Juan Antonio Costa-Orvay. The effects of varying
protein and energy intakes on the growth and body composition of very low birth
weight infants. Nutrition Journal 2011, 10:140 doi:10.1186/1475-2891-10-140
2. Extremely Low Birth Weight Infant information