Preterm

Preterm infants miss crucial weeks of nutrient accumulation during the third trimester, leading to depleted stores and high nutritional needs¹. Approximately 8% of UK babies are born prematurely, facing risks like developmental delays, growth failure, gastrointestinal issues, and medical complications². Feeding intolerance is a significant concern, with up to 50% of preterm infants experiencing delays in achieving full enteral feeding, resulting in suboptimal nutrient intake and reduced growth rates^3,4.

Preterm baby postnatal growth restriction is common due to feeding challenges, particularly in very premature infants^5–7. This growth restriction can lead to impaired neurodevelopment, with greater growth deficits linked to more significant neurodevelopment impairments^8–10.

The primary goal of nutritional management is to prevent growth failure and protect brain development⁹. Increased nutrients, especially protein and energy, are associated with positive developmental outcomes¹¹.

The Preterm Hub will provide resources on feeding preterm infants, addressing nutritional challenges, the tolerance benefits of partially hydrolysed protein, iron requirements, weaning, and clinical studies on skin-to-skin contact.

According to ESPGHAN guidelines, use of a multicomponent fortifier enhances the nutrient content of human milk for preterm infants¹². Ideally, mothers' own milk (MOM) is preferred, followed by fortified donor human milk (DHM) if MOM is insufficient¹². Breast milk offers significant benefits, including lower rates of necrotising enterocolitis and neurodevelopmental advantages^{13, 14}.

ESPGHAN recommends fortifying preterm breast milk to correct decreasing protein content, ensuring improved nutritional status and growth^{15, 16}. If breast milk is unavailable, a preterm infant formula should be used, with hydrolysed protein feeds aiding gastrointestinal transit and enteral feeding advancement^1,12.