Abstract
The ultimate goal of neonatal nutrition care is optimal growth, neurodevelopment, and long-term health for preterm babies. International consensus is that increased energy and protein intakes in the neonatal period improve growth and neurodevelopment, but after more than 100 y of research the optimum intakes of energy and protein remain unknown. We suggest an important factor contributing to the lack of progress is the lack of a standardized approach to reporting nutritional intake data and growth in the neonatal literature. We reviewed randomized controlled trials and observational studies documented in MEDLINE and the Web of Science from 2008 to 2015 that compared approximately 3 vs. 4 g.kg(-1).d(-1) protein for preterm babies in the first month after birth. Consistency might be expected in the calculation of nutritional intake and assessment of growth outcomes in this relatively narrow scope of neonatal nutrition research. Twenty-two studies were reviewed. There was substantial variation in methods used to estimate and calculate nutritional intakes and in the approaches used in reporting these intakes and measures of infant growth. Such variability makes comparisons amongst studies difficult and meta-analysis unreliable. We propose the StRONNG Checklist-Standardized Reporting Of Neonatal Nutrition and Growth to address these issues.
Highlights
For preterm babies, nutrition in early life is recognized as a key determinant of improving neonatal outcomes: survival; optimal growth; neurodevelopment, and long-term health (1)
20th century metabolic studies estimated the energy and protein requirements of late preterm babies, but despite over 1,000 publications on neonatal nutrition and growth, a 2014 review of clinical trials on parenteral nutrition for extremely preterm babies concluded that the “cardinal unresolved questions are the optimal protein and energy intakes and the growth velocity that is predictive of optimal long-term health (3).”
To investigate the variability in reporting, we identified and reviewed recent randomized controlled trials and observational studies documented in MEDLINE and the Web of Science from 2008 to 2015 that compared approximately 3 vs. 4 g.kg–1.d–1 protein for preterm babies in the first month after birth
Summary
Nutrition in early life is recognized as a key determinant of improving neonatal outcomes: survival; optimal growth; neurodevelopment, and long-term health (1). 20th century metabolic studies estimated the energy and protein requirements of late preterm babies, but despite over 1,000 publications on neonatal nutrition and growth, a 2014 review of clinical trials on parenteral nutrition for extremely preterm babies concluded that the “cardinal unresolved questions are the optimal protein and energy intakes and the growth velocity that is predictive of optimal long-term health (3).”. It is difficult to find even two studies where the same references or methods have been used to determine nutritional intake or growth outcomes (Tables 1 and 2; Supplementary Table S1 online). These differences make the body of neonatal nutrition research. Total and parenteral intake by week for each of the first 4 weeks; Cumulative total and parenteral non protein energy day 1 to 28
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