E-ISSN 1858-8360 | ISSN 0256-4408
 

Review Article 


Feeding growth restricted premature neonates: a challenging perspective

Siba Prosad Paul, Emily Natasha Kirkham, Katherine Amy Hawton, Paul Anthony Mannix.

Abstract
Nutrition in the postnatal period is essential to achieve optimal growth and maintain biochemical normality. Feeding growth restricted premature neonates remains a big challenge for neonatologists. The choice of milk is one of the biggest challenges. Breast milk is recommended although feeding with preterm formulas can ensure a more consistent delivery of optimal levels of nutrients. The timing of introduction of feeds and the rate of advancement of those feeds in preterm infants are both topics of significant controversy.

Early feeding is advantageous because it improves the functional adaptation of the gastrointestinal tract and reduces the duration of total parenteral nutrition. A faster rate of advancement will also reduce the duration of parenteral nutrition. Despite this, enteral feeding is often delayed and is often slowly increased in high risk infants because of a possible increased risk of necrotising enterocolitis (NEC).

Growth restricted neonates are at increased risk of developing NEC due to a combination of antenatal and postnatal disturbances in gut perfusion. If enteral feeding is introduced earlier and advanced more quickly this may lead to increased risk of NEC, but slower feeds extends the duration of parenteral nutrition, and its risks, and may have adverse consequences for survival, growth and development.

Premature infants pose a significant nutritional challenge. Overall, we would suggest preferential use of human milk, early minimal enteral feeds and standardized feeding protocols with cautious advancements of feeds to facilitate gastrointestinal adaptation and reduce the risk of NEC, but further research is needed.

Key words: Small for gestational age; Absent or reversed end-diastolic flow velocities; Necrotizing enterocolitis; Breast milk; Total parenteral nutrition;


 
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How to Cite this Article
Pubmed Style

Paul SP, Kirkham EN, Hawton KA, Mannix PA. Feeding growth restricted premature neonates: a challenging perspective. Sudan J Paed. 2018; 18(2): 5-14. doi:10.24911/SJP.106-1519511375


Web Style

Paul SP, Kirkham EN, Hawton KA, Mannix PA. Feeding growth restricted premature neonates: a challenging perspective. http://www.sudanjp.com/?mno=291974 [Access: January 17, 2019]. doi:10.24911/SJP.106-1519511375


AMA (American Medical Association) Style

Paul SP, Kirkham EN, Hawton KA, Mannix PA. Feeding growth restricted premature neonates: a challenging perspective. Sudan J Paed. 2018; 18(2): 5-14. doi:10.24911/SJP.106-1519511375



Vancouver/ICMJE Style

Paul SP, Kirkham EN, Hawton KA, Mannix PA. Feeding growth restricted premature neonates: a challenging perspective. Sudan J Paed. (2018), [cited January 17, 2019]; 18(2): 5-14. doi:10.24911/SJP.106-1519511375



Harvard Style

Paul, S. P., Kirkham, . E. N., Hawton, . K. A. & Mannix, . P. A. (2018) Feeding growth restricted premature neonates: a challenging perspective. Sudan J Paed, 18 (2), 5-14. doi:10.24911/SJP.106-1519511375



Turabian Style

Paul, Siba Prosad, Emily Natasha Kirkham, Katherine Amy Hawton, and Paul Anthony Mannix. 2018. Feeding growth restricted premature neonates: a challenging perspective. Sudanese Journal of Paediatrics, 18 (2), 5-14. doi:10.24911/SJP.106-1519511375



Chicago Style

Paul, Siba Prosad, Emily Natasha Kirkham, Katherine Amy Hawton, and Paul Anthony Mannix. "Feeding growth restricted premature neonates: a challenging perspective." Sudanese Journal of Paediatrics 18 (2018), 5-14. doi:10.24911/SJP.106-1519511375



MLA (The Modern Language Association) Style

Paul, Siba Prosad, Emily Natasha Kirkham, Katherine Amy Hawton, and Paul Anthony Mannix. "Feeding growth restricted premature neonates: a challenging perspective." Sudanese Journal of Paediatrics 18.2 (2018), 5-14. Print. doi:10.24911/SJP.106-1519511375



APA (American Psychological Association) Style

Paul, S. P., Kirkham, . E. N., Hawton, . K. A. & Mannix, . P. A. (2018) Feeding growth restricted premature neonates: a challenging perspective. Sudanese Journal of Paediatrics, 18 (2), 5-14. doi:10.24911/SJP.106-1519511375





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