INCREMENTAL GROWTH IN THE SMALL PREMATURE INFANT

Abstract

In order to provide a baseline for assessment of the effect of early high caloric alimentation in the small premature infant, a group of infants, gestation of 32 weeks or less and birth weights within 2 standard deviations of the mean, received only a 20-calorie/oz. Similac formula supplemented by 10% G/W iv. to provide a daily fluid intake of 120cc./kg by day 3. The average caloric intake at 1 week was 101±26 cal/kg./d. 65 of the 82 survivors were seen at the estimated date of delivery (EDD) and then at 3 month intervals for 1 year. Using the EDD as birthdate equivalent, actual size and rates of linear and weight growth were compared with similar data from 24 normal full term infants. Rates of linear growth for both sexes were identical to those of the full term. The mean length was at the 50th percentile of the Stuart grid throughout the first year. Rate of weight growth tended to be slower for the first 6 months although the difference was significant only for girls. Mean weight fell between the 3rd and 50th percentiles. Head growth was accelerated the first 3 months but approximated the 50th percentile thereafter. Smaller stature at 1 year was associated with a low caloric intake at 1 week (mean 84cal/kg/d). The mean developmental quotient was 92 uncorrected, 108 corrected, and was unrelated to early caloric intake. The results suggest that prolonged early undernutrition is associated with decreased weight growth the first 6 months post-term.