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- Title
Nutritional Strategies for Preterm Neonates and Preterm Neonates Undergoing Surgery: New Insights for Practice and Wrong Beliefs to Uproot.
- Authors
De Rose, Domenico Umberto; Lapillonne, Alexandre; Iacobelli, Silvia; Capolupo, Irma; Dotta, Andrea; Salvatori, Guglielmo
- Abstract
The nutrition of preterm infants remains contaminated by wrong beliefs that reflect inexactitudes and perpetuate old practices. In this narrative review, we report current evidence in preterm neonates and in preterm neonates undergoing surgery. Convictions that necrotizing enterocolitis is reduced by the delay in introducing enteral feeding, a slow advancement in enteral feeds, and the systematic control of residual gastric volumes, should be abandoned. On the contrary, these practices prolong the time to reach full enteral feeding. The length of parenteral nutrition should be as short as possible to reduce the infectious risk. Intrauterine growth restriction, hemodynamic and respiratory instability, and patent ductus arteriosus should be considered in advancing enteral feeds, but they must not translate into prolonged fasting, which can be equally dangerous. Clinicians should also keep in mind the risk of refeeding syndrome in case of high amino acid intake and inadequate electrolyte supply, closely monitoring them. Conversely, when preterm infants undergo surgery, nutritional strategies are still based on retrospective studies and opinions rather than on randomized controlled trials. Finally, this review also highlights how the use of adequately fortified human milk is strongly recommended, as it offers unique benefits for immune and gastrointestinal health and neurodevelopmental outcomes.
- Subjects
INFECTION risk factors; INFANTS; RISK assessment; PARENTERAL feeding; FETAL growth retardation; NUTRITIONAL requirements; BREAST milk; EVALUATION of medical care; ENTERAL feeding; NEONATAL necrotizing enterocolitis; ELECTROLYTES; AMINO acids; ENRICHED foods; REFEEDING syndrome; DISEASE risk factors
- Publication
Nutrients, 2024, Vol 16, Issue 11, p1719
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu16111719