Nutritional Recommendations for the Very-Low-Birth-Weight Newborn

Abstract

To ensure uninterrupted growth and development of the prematurely born infant, all nutrients must be provided in the necessary amounts at all times. Delivery of nutrients meets with a variety of obstacles in very low birth weight (VLBW) infants, which is why VLBW infants frequently receive less than the required amounts of nutrients. As a consequence they often fail to grow like they would have in utero and, more importantly, suffer impairment of their neurocognitive development. The main obstacles to delivery of nutrients historically have been concerns regarding presumed risks attendant to the administration of nutrients. Recent years have seen a gradual dissipation of these concerns as scientific evidence of the safety of providing nutrients has accumulated. This reassessment of the risks of nutrient administration has nearly been completed in the area of parenteral nutrition but is an ongoing process in the area of enteral nutrition. The more realistic assessment of risks, together with a desire to prevent postnatal growth failure and thereby minimize the risk of impaired neurocognitive impairment, has led to more aggressive regimens of nutrient administration.