Guidelines and recommendations for feeding preterm infants

• Early feeding choices of preterm infants aim to achieve early catch-up growth as well as reducing long term growth deficits and risk of potential adverse events in adulthood¹ 

• The European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) states “those preterm infants who fail to achieve their growth potential during the first weeks of postnatal life have a less favourable outcome with respect to growth and neurodevelopment”¹ 

• Nutritional treatment is a cornerstone in the management of preterm infants².  Recent advances in the field of nutrition have helped greatly in achieving better outcomes for this vulnerable group, resulting in specific guidelines for the minimum and maximum nutrient requirements for low birthweight infants (LBW), very low birthweight infants (VLBW) and extremely low birthweight infants (ELBW)

Tsang 2005

• The latest guidelines in this area are the ‘Tsang guidelines’ from 2005 ², which replace the previous version from 1993 

• These guidelines bring together several experts from the field to present their latest findings, review the relevant literature and to discuss any issues².  The topics include recommendations for nutrients and energy intakes and the role of specific nutrients, such as proteins, carbohydrates, lipids, water and electrolytes, and vitamins and minerals² 

• The Tsang guidelines also provide information on the roles of breast milk, enteral and parenteral nutrition, feeding an infant after hospital discharge, and growth, development and long term effects²

Life Sciences Research Office (LSRO)

• In 2002, guidelines were released from the Life Sciences Research Office (LSRO) in the US recommending the nutrient content of infant formulas intended for preterm and low-birthweight (LBW) infants³  

• LSRO is made up of non-profit organisations who have both permanent staff and an established network of world experts and consultants.  They help to provide objective, independent scientific advice to decision makers in industry and government 

• The LSRO expert panel evaluated the science with regards to specific nutrients, and the evidence to support the need for separate recommendations based on the premature infant’s transition across several stages of clinical care, from birth to discharge from the hospital³