When a preterm infant is born, the rich supply of nutrients that has supported the growth and development of the foetus up to this point is interrupted. It is in principle, widely agreed that the supply of the nutrients should be restored promptly and that they should be provided in amounts that allow the premature infant to grow like the foetus, in body velocity as well as body composition.
In practice, delivering adequate amounts of nutrients to premature infants is challenging because the infant’s immature gastrointestinal tract is initially unable to tolerate feeds, necessitating the use of parenteral nutrition. Inadequate nutrient intakes have resulted in widespread postnatal growth restriction.
It is now known that a preterm baby growth restriction is associated with poor neurocognitive development, therefore, efforts are made to increase nutrient intakes.
In this review, the nutritional requirements of preterm babies are discussed, as well as current good practices regarding parenteral nutrition and guidelines for the introduction and advancement of enteral feeding.
Human milk and nutrient fortification
Human milk protects infants against necrotising enterocolitis. Once full feeding is achieved, the challenge is to provide the preterm baby with nutrients in amounts that support the infant’s growth like that of the foetus. In the case of the infant fed his/her mother’s milk or banked donor milk, nutrient fortification is necessary and is generally practiced, however, adequate intakes of protein are seldom achieved with routine fortification and methods of providing additional fortification are discussed.