A Review on the Practical Approach to Nutritional Management of Preterm Infants: Indian Perspective
Journal Title: Indian Journal of Nutrition - Year 2017, Vol 4, Issue 1
Abstract
Worldwide, more than 15 million babies are born prematurely every year. Of these, 1 million die, and many surviving infants face a lifetime of disability. A striking 24% of the world’s preterm births occur in India, which represents a total of 3.5 million preterm births every year. Infants born prematurely are at a higher risk than term infants for infections, impaired neurodevelopment, and poor growth. Short and long-term health outcomes can be improved by initiating feeds promptly and advancing progressively. Feeding usually involves multiple approaches such as early parenteral nutrition, orogastric or nasogastric enteral tube feeding, and ultimately oral feeding. The starting feed and the timing of progression depend on an infant’s age and weight at birth, the baby’s ability to coordinate breathing with sucking and swallowing, and gut maturity. The nutrient needs of preterm infants are higher than that of term infants. Parenteral nutrition must supply adequate amino acids and energy. For enteral feeds, mother’s milk is ideal but must be fortified with additional protein, energy, vitamins, and minerals. When the infant is ready for oral feeding, fortified mother’s milk is the first choice. Human milk banks, wherever available, should be considered as the first alternative when mother’s milk is unavailable or insufficient. If both options are not available, the use of nutrient-rich preterm formula is appropriate. To promote intact survival among infants born prematurely, our paper includes a stepwise feeding plan and tools for decision making.
Authors and Affiliations
Umesh Vaidya
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