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UEG Standards and Guidelines

Position Paper

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Feeding the Late and Moderately Preterm Infant

A. Lapillonne

Summary

AI Generated

The ESPGHAN Committee on Nutrition reviewed feeding guidance for late or moderately preterm infants, a large but understudied population with notable nutritional vulnerabilities and limited evidence from controlled trials.

Late or moderately preterm infants have unique vulnerabilities that predispose them to high rates of nutritionally related morbidity, hospital readmissions, feeding difficulties delaying discharge, and poorer breastfeeding rates compared with term infants, while moderately preterm infants frequently exhibit postnatal growth restriction
ESPGHAN strongly endorses breast milk as the preferred feeding method and emphasizes that mothers should receive qualified, extended lactation support and frequent follow-up with individualized feeding plans promoted
The need for active nutritional support increases with lower gestational ages, with potential roles for human milk fortifier, enriched formula, parenteral nutrition, or supplements depending on gestational age, birth weight, and comorbidities
Hospital discharge should be delayed until a safe discharge plan is established that accounts for local situation and resources
Further research is needed to assess benefits of improved nutrient intakes versus risks of interrupting breastfeeding when providing nutrient-enrichment to this population

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Guideline

Abstract

Nutritional guidelines and requirements for late or moderately preterm (LMPT) infants are notably absent, although they represent the largest population of preterm infants. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition (CoN) performed a review of the literature with the aim to provide guidance on how to feed infants born LMPT, and identify gaps in the literature and research priorities.

Only limited data from controlled trials are available. Late preterm infants have unique, often unrecognized, vulnerabilities that predispose them to high rates of nutritionally related morbidity and hospital readmissions. They frequently have feeding difficulties that delay hospital discharge, and poorer rates of breastfeeding initiation and duration compared with term infants. This review also identified that moderately preterm infants frequently exhibit postnatal growth restriction.

The ESPGHAN CoN strongly endorses breast milk as the preferred method of feeding LMPT infants and also emphasizes that mothers of LMPT infants should receive qualified, extended lactation support, and frequent follow-up. Individualized feeding plans should be promoted. Hospital discharge should be delayed until LMPT infants have a safe discharge plan that takes into account local situation and resources.

In the LMPT population, the need for active nutritional support increases with lower gestational ages. There may be a role for enhanced nutritional support including the use of human milk fortifier, enriched formula, parenteral nutrition, and/or additional supplements, depending on factors, such as gestational age, birth weight, and significant comorbidities. Further research is needed to assess the benefits (improved nutrient intakes) versus risks (interruption of breast-feeding) of providing nutrient-enrichment to the LMPT infant.

Publisher

European Society for Paediatric Gastroenterology, Hepatology and Nutrition

Guideline

Position Paper

Topics

Paediatrics Small Intestine & Nutrition

Citation

Journal of Pediatric Gastroenterology and Nutrition, 69: 259-270

Published

2019

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Using big data and AI for personalised therapy in metabolic liver diseases

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