Formula-fed preterm neonates

Abstract

In very immature babies, nutrition often begined with human milk, but a lot of mothers have a difficulty in lactating and banked human milk is not always available. Therefore, preterm formulas have been specifically designed for very low birth weight (VLBW) infants during hospitalisation stay. They differ significantly from standard term formulas and their derivatives, such as extensively hydrolyzed protein formulas, which are not nutritionally adapted for these infants. Partially hydrolyzed protein formulas have been tried, but infants fed these formulas have a decreased nitrogen intestinal absorption rate. As a result the nitrogen content needs to be increased each time a partially hydrolyzed protein source is used in preterm formulas instead of an entire protein source. Although mineral retention in VLBW infants fed a formula is lower than in utero it might be sufficient. We recently observed an early catch up of bone mineralisation at theoretical term in VLBW infants fed a preterm formula containing highly soluble calcium salts. Probiotics and prebiotics are not yet well evaluated in preterm infants but might help in improving the development of physiologic intestinal flora and enteral feeding tolerance. There is still debate about optimal posthospital nutrition in preterm infants who are not breastfed. Feeding a nutrient-enriched formula provides a growth benefit when compared to infants fed a term formula, mainly during the first 2 to 3 months after discharge. Data about the harmful effects of using such formulas for a longer period are scarce. Therefore, the use of nutrient-enriched formula might be suggested for the first 2 months after discharge, as it is a crucial period in the development of these VLBW infants.