*
Nicholas David Embleton, MBBS, BSc, MD,
†
Sissel Jennifer Moltu, MD, PhD,
‡§
Alexandre Lapillonne, MD, PhD,
||
Chris H.P. van den Akker, MD, PhD,
¶
Virgilio Carnielli, MD, PhD,
#**
Christoph Fusch, MD, PhD,
††
Konstantinos Gerasimidis, PhD,
‡‡
Johannes B. van Goudoever, MD, PhD, §§
Nadja Haiden, MD, MSc,
||||
Silvia Iacobelli, MD, PhD,
¶¶##
Mark J. Johnson, BM, BSc, PhD, ***
Sascha Meyer, MD, PhD,
†††‡‡‡
Walter Mihatsch, MD, MBA,
§§§
Miguel Saenz de Pipaon, MD, PhD,
||||||
Jacques Rigo, MD, PhD,
¶¶¶
Gitte Zachariassen, MD, PhD,
###
Jiri Bronsky, MD, PhD, ****
Flavia Indrio, MD, PhD,
††††
Jutta Köglmeier, MD, PhD,
‡‡‡‡
Barbara de Koning, MD, PhD,
§§§§
Lorenzo Norsa, MD, PhD,
||||||||¶¶¶¶
Elvira Verduci, MD, PhD, and
####
Magnus Domellöf, MD, PhD
Objectives: To review the current literature and develop consensus conclusions
and recommendations on nutrient intakes and nutritional practice in
preterm infants with birthweight <1800 g.
Methods: The European Society of Pediatric Gastroenterology, Hepatology
and Nutrition (ESPGHAN) Committee of Nutrition (CoN) led a process that
included CoN members and invited experts. Invited experts with speciffc
expertise were chosen to represent as broad a geographical spread as possible.
A list of topics was developed, and individual leads were assigned to topics
along with other members, who reviewed the current literature. A single faceto-face
meeting was held in February 2020. Provisional conclusions and recommendations
were developed between 2020 and 2021, and these were voted
on electronically by all members of the working group between 2021 and
2022. Where >90% consensus was not achieved, online discussion meetings
were held, along with further voting until agreement was reached.
Results: In general, there is a lack of strong evidence for most nutrients and
topics. The summary paper is supported by additional supplementary digital
content that provide a fuller explanation of the literature and relevant physiology:
introduction and overview; human milk reference data; intakes of water, protein,
energy, lipid, carbohydrate, electrolytes, minerals, trace elements, water soluble
vitamins, and fat soluble vitamins; feeding mode including mineral enteral feeding,
feed advancement, management of gastric residuals, gastric tube placement
and bolus or continuous feeding; growth; breastmilk buccal colostrum, donor
human milk, and risks of cytomegalovirus infection; hydrolyzed protein and
osmolality; supplemental bionutrients; and use of breastmilk fortiffer.
Conclusions: We provide updated ESPGHAN CoN consensus-based conclusions
and recommendations on nutrient intakes and nutritional management
for preterm infants
Key Words: enteral nutrition, neonatal intensive care unit, neonate,
nutritional requirements, preterm infant |
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