Iranian Journal of Neonatology

Iranian Journal of Neonatology

The Impacts of Varying Protein and Energy Intakes on the Growth of Neonates with Very Low Birth Weight : An Experimental Study

Document Type : Original Article

Authors
Sara Esmaelzadeh Saeieh 1
Badri Farhand 2
Elahe Dehghan Nayeri 3
Ashkan Torabi Kashani 4
Alireza Jashni Motlagh 5
1 Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
2 Neonatal Intensive Care Nursing, Clinical Research and Development of Kamali Hospital Center, Alborz University of Medical Sciences, Karaj, Iran
3 Clinical Research and Development of Kamali Hospital Center, Alborz University of Medical Sciences, Karaj, Iran
4 Medical student, School of medicine, Alborz University of Medical Sciences, Karaj, Iran
5 School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
10.22038/ijn.2024.70246.2366
Abstract
Background: Studies have indicated contradictory results concerning the impact of protein-based diets on very low birth weight neonates. Hence, this study explored the impacts of various calorie and protein diets on the growth of very low birth weight neonate during 15 days.
Methods: This study was carried out on 44 neonates with very low birth weight, selected regarding the inclusion criteria. They were assigned into two clusters based on their birth weight. Each cluster included a control group receiving the standard diet formula, and an experimental group with neonates weighing 1000-1500gr who followed a high-energy diet with 4gr protein and those weighing less than 1000gr who received a high-energy diet with 4.2gr protein. Finally, the neonates' weight, height, and head circumference were measured every 3 days for 15 days.
Results: According to the findings, the mean weight of  the neonates who weighed between 1000 and 1500gr was higher in the intervention group from the third day after initiating the diet, though no significant difference was observed. Similarly, the mean weight of intervention group in the second cluster was higher than the neonates in the control group from the third day with a statistically significant difference on the 15th day. Moreover, no significant difference was found in other measurements between groups.
Conclusion: The results demonstrated the effect of a higher weight of protein intake group on the 15th day. Hence, it recommends providing higher protein intake formula to lower infant birth weight for better growth.
 
 
Keywords
High calories
High protein
Neonate
Very low birth weight
  1. Dutta S, Singh B, Chessell L, Wilson J, Janes M, McDonald K, et al. Guidelines for feeding very low birth weight infants. Nutrients. 2015;7(1):423-42.
  2. Denne SC. Protein and energy requirements in preterm infants. In Seminars in neonatology 2001;6(5):377-382. WB Saunders.
  3. Su BH. Optimizing nutrition in preterm infants. Pediatr Neonatol. 2014;55(1):5-13.
  4. Thureen PJ. Early aggressive nutrition in the neonate. Pediatr Rev. 1999; 20(9):e45-55.
  5. Sakurai M, Itabashi K, Sato Y, Hibino S, Mizuno K. Extrauterine growth restriction in preterm infants of gestational age < or =32 weeks. Pediatr Int. 2008;50(1):70-75.
  6. Cooke RJ, Ainsworth SB, Fenton AC. Postnatal growth retardation: a universal problem in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2004;89(5):F428-30.
  7. Ehrenkranz RA, Younes N, Lemons JA, Fanaroff AA, Donovan EF, Wright LL, et al. Longitudinal growth of hospitalized very low birth weight infants. Pediatrics. 1999;104(2):280-9.
  8. McCallie KR, Lee HC, Mayer O, Cohen RS, Hintz SR, Rhine WD. Improved outcomes with a standardized feeding protocol for very low birth weight infants. J Perinatol. 2011;Suppl 1:S61-7.
  9. Rochow N, Fusch G, Mühlinghaus A, Niesytto C, Straube S, Utzig N, et al. A nutritional program to improve outcome of very low birth weight infants. Clin Nutr. 2012;31(1):124-131.
  10. Härtel C, Haase B, Browning-Carmo K, Gebauer C, Kattner E, Kribs A, et al. Does the enteral feeding advancement affect short-term outcomes in very low birth weight infants? J Pediatr Gastroenterol Nutr. 2009;48(4):464-470.
  11. Flidel-Rimon O, Friedman S, Lev E, Juster-Reicher A, Amitay M, Shinwell ES. Early enteral feeding and nosocomial sepsis in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed. 2004;89(4):F289-292.
  12. Krishnamurthy S, Gupta P, Debnath S, Gomber S. Slow versus rapid enteral feeding advancement in preterm newborn infants 1000-1499 g: a randomized controlled trial. Acta Paediatr. 2010;99(1):42-46.
  13. Dhingra A, Agrawal SK, Kumar P, Narang A. A randomised controlled trial of two feeding schedules in neonates weighing <or=1750 g. J Matern Fetal Neonatal Med. 2009;22(3):198-203.
  14. Rüdiger M, Herrmann S, Schmalisch G, Wauer RR, Hammer H, Tschirch E. Comparison of 2-h versus 3-h enteral feeding in extremely low birth weight infants, commencing after birth. Acta Paediatr. 2008;97(6):764-769.
  15. Schanler RJ. Outcomes of human milk-fed premature infants. Semin Perinatol. 2011;35(1):29-33.
  16. Sullivan S, Schanler RJ, Kim JH, Patel AL, Trawöger R, Kiechl-Kohlendorfer U, et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr. 2010;156(4):562-567.e1.
  17. Cristofalo EA, Schanler RJ, Blanco CL, Sullivan S, Trawoeger R, Kiechl-Kohlendorfer U, et al. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. J Pediatr. 2013; 163(6):1592-5. e1.
  18. Schanler RJ, Lau C, Hurst NM, Smith EO. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics. 2005;116(2):400-406.
  19. Romera G, Figueras J, Rodríguez-Miguélez JM, Ortega J, Jiménez R. Energy intake, metabolic balance and growth in preterm infants fed formulas with different nonprotein energy supplements. J Pediatr Gastroenterol Nutr. 2004;38(4):407-413.
  20. Ganapathy V, Hay JW, Kim JH. Costs of necrotizing enterocolitis and cost-effectiveness of exclusively human milk-based products in feeding extremely premature infants. Breastfeed Med. 2012;7(1):29-37.
  21. Ziegler EE. Meeting the nutritional needs of the low-birth-weight infant. Ann Nutr Metab. 2011;58(Suppl 1):8-18.
  22. Whitfield JM, Hendrikson H. Prevention of protein deprivation in the extremely low birth weight infant: a nutritional emergency. Proc (Bayl Univ Med Cent). 2006;19(3):229-231.
  23. Ehrenkranz RA, Dusick AM, Vohr BR, Wright LL, Wrage LA, Poole WK. Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatrics. 2006;117(4):1253-1261.
  24. Shah MD, Shah SR. Nutrient deficiencies in the premature infant. Pediatr Clin North Am. 2009; 56(5):1069-1083.
  25. Agostoni C, Buonocore G, Carnielli VP, De Curtis M, Darmaun D, Decsi T, et al; ESPGHAN Committee on Nutrition. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010; 50(1):85-91.
  26. Costa-Orvay JA, Figueras-Aloy J, Romera G, Closa-Monasterolo R, Carbonell-Estrany X. The effects of varying protein and energy intakes on the growth and body composition of very low birth weight neonates. Nutr J. 2011; 10:140.
  27. Kashyap S. Enteral intake for very low birth weight infants: what should the composition be? Semin Perinatol. 2007;31(2):74-82.
  28. Section on Breastfeeding, Eidelman AI, Schanler RJ, Johnston M, Landers S, Noble L, et al. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-841.
  29. Spiegler J, Preuß M, Gebauer C, Bendiks M, Herting E, Göpel W; German Neonatal Network (GNN); German Neonatal Network GNN. Does breastmilk influence the development of bronchopulmonary dysplasia? J Pediatr. 2016;169:76-80.e4.
  30. O'Connor DL, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, et al. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight neonates at 18 months: a randomized clinical trial. Jama 2016; 316(18):1897-905.
Iranian Journal of Neonatology
Volume 15, Issue 2
Spring 2024
Pages 43-48