Feeding Preterm Infants after Hospital Discharge: Effect of Dietary Manipulation on Nutrient Intake and Growth

Abstract

The objective of this study was to compare formula intake, the time of weaning, and growth in preterm infants (< or = 1750-g birth weight, < or = 34-wk gestation) fed a standard term or preterm infant formula after initial hospital discharge. Infants were randomized at hospital discharge to be fed a preterm infant formula from discharge to 6 mo corrected age (group A), a term formula from discharge to 6 mo (group B), or the preterm formula (discharge to term) and the term formula (term to 6 mo (group C). Infants were seen biweekly (discharge to term) and monthly (term to 6 mo), when intake was measured and anthropometry and blood sampling were performed. The results were analyzed using ANOVA. Although nutrient intake was similar, at 6 mo girls were lighter (6829 versus 7280 g) and shorter (64.4 versus 66.0 cm) than boys (p < 0.05). Patient characteristics were similar between the treatment groups. Although the volume of intake differed (B > C > A; p < 0.001), energy intake was similar in the groups. Because of differences in formula composition, protein, calcium, and phosphorus intakes differed (B < C < A; p < 0.001). Lower protein intakes were related to lower blood urea nitrogen levels (B < C < A; p < 0.001). At 6 mo, infant boys in B and C were lighter (6933, 6660 < 7949 g), shorter (65.3, 64.9 < 67.1 cm), and had a smaller head circumference (43.7, 43.7 < 44.8 cm; p < 0.05) than infants in group A. Preterm infants were found to increase their volume of intake to compensate for differences in energy density between formulas. After hospital discharge, infant boys fed a preterm formula grew faster than infant girls fed a preterm formula or infant boys fed a term formula.