CSPEN guidelines for nutrition support in neonates.

Abstract

In the last few decades, there has been a significant increase in survival rate of preterm infants, especially very low birth weight infants. The nutrition problems have become particularly relevant in neonates, and nutrition support is usually required for preterm infants and most sick term infants. The actual amount of nutrition must be calculated (not estimated) in neonates. The goals of nutrition support are to maintain development and growth while avoiding nutrition related complications. Nutrition requirements (enteral nutrition and parenteral nutrition) should be adjusted according to different weights and gestational age. Parenteral nutrition (PN), which allows the infant's requirements for growth and development to be met, is indicated in infants for whom feeding via the enteral route is impossible, inadequate, or hazardous. Enteral nutrition (EN) should be gradually introduced and should replace PN as quickly as possible in order to minimize any side-effects from exposure to PN. Inadequate substrate intake in early infancy can cause long-term detrimental effects in terms of metabolic programming of the risk of illness in later life. Optimal nutrition care of the preterm infant offers the opportunity to improve outcomes for children. This guideline aims to provide proposed advisable ranges for nutrient intakes in neonates. These recommendations are based on a considered review of available scientific reports on the subject, and on expert consensus for which the available scientific data are considered inadequate.