Randomized Controlled Trial of Two Timepoints for Introduction of Standardized Complementary Food in Preterm Infants.

Nadja Haiden,Melanie Gsoellpointner,Fabian Eibensteiner,Margit Kornsteiner-Krenn,Bernd Jilma,Christoph Binder,Margarita Thanhaeuser,Alexandra Thajer,Robin Ristl,Bettina Kroyer,Sophia Brandstetter,Mercedes Huber-Dangl

doi:10.3390/nu14030697

Abstract

In term infants it is recommended to introduce solids between the 17th and 26th week of life, whereas data for preterm infants are missing. In a prospective, two-arm interventional study we investigated longitudinal growth of VLBW infants after early (10–12th) or late (16–18th) week of life, corrected for term, introduction of standardized complementary food. Primary endpoint was height at one year of age, corrected for term, and secondary endpoints were other anthropometric parameters such as weight, head circumference, BMI, and z-scores. Among 177 infants who underwent randomization, the primary outcome could be assessed in 83 (93%) assigned to the early and 83 (94%) to the late group. Mean birthweight was 941 (SD ± 253) g in the early and 932 (SD ± 256) g in the late group, mean gestational age at birth was 27 + 1/7 weeks in both groups. Height was 74.7 (mean; SD ± 2.7) cm in the early and 74.4 cm (mean; SD ± 2.8; n.s.) cm in the late group at one year of age, corrected for term. There were no differences in anthropometric parameters between the study groups except for a transient effect on weight z-score at 6 months. In preterm infants, starting solids should rather be related to neurological ability than to considerations of nutritional intake and growth.

Highlights

Adequate nutrition and growth during the first 1000 days, from conception to the second year of life, are crucial for a later healthy life and appropriate neurodevelopment, especially in preterm infants [1]
We planned a randomized study in preterm infants with a birthweight below 1500 g, investigating whether the timepoint of introduction of standardized complementary food influences growth at 12 months, corrected for term
An Italian study documented that infants born between 24–32 weeks were weaned from exclusive nursing or formula feeding at 13 weeks, corrected for term, while more mature infants born between 33–36 weeks were weaned at 15 weeks, corrected for term [4], indicating that the degree of prematurity is a major determinant for complementary food introduction

Summary

Introduction

Adequate nutrition and growth during the first 1000 days, from conception to the second year of life, are crucial for a later healthy life and appropriate neurodevelopment, especially in preterm infants [1]. Only two interventional RCTs on the timing for initiation of complementary food in preterm infants were conducted investigating growth during the first year of life [6,7]. These studies were performed under expired settings and different environmental conditions, making a general application of the results impossible. We planned a randomized study in preterm infants with a birthweight below 1500 g, investigating whether the timepoint of introduction of standardized complementary food influences growth at 12 months, corrected for term

Methods

Results

Discussion

Conclusion