Nutrients

Editorial

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Open AccessEditorial

Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes

by Antonios K. Gounaris and Rozeta Sokou

Nutrients 2024, 16(2), 218; https://doi.org/10.3390/nu16020218 - 10 Jan 2024

Cited by 1 | Viewed by 1375

Abstract

The Special Issue has been completed with the publication of 13 review and research articles [...] Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

Research

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13 pages, 945 KiB

Open AccessArticle

The Prevalence of Small for Gestational Age and Extrauterine Growth Restriction among Extremely and Very Preterm Neonates, Using Different Growth Curves, and Its Association with Clinical and Nutritional Factors

by Ioanna Kakatsaki, Styliani Papanikolaou, Theano Roumeliotaki, Nicolina Hilda Anagnostatou, Ioanna Lygerou and Eleftheria Hatzidaki

Nutrients 2023, 15(15), 3290; https://doi.org/10.3390/nu15153290 - 25 Jul 2023

Cited by 3 | Viewed by 1556

Abstract

Monitoring the growth of neonates in the Neonatal Intensive Care Unit (NICU) using growth charts constitutes an essential part of preterm infant care. Preterm infants are at increased risk for extrauterine growth restriction (EUGR) due to increased energy needs and clinical complications. This [...] Read more.

Monitoring the growth of neonates in the Neonatal Intensive Care Unit (NICU) using growth charts constitutes an essential part of preterm infant care. Preterm infants are at increased risk for extrauterine growth restriction (EUGR) due to increased energy needs and clinical complications. This retrospective study compares the prevalence of small for gestational age (SGA) at birth and EUGR at discharge in extremely and very preterm neonates hospitalized in the NICU of a tertiary hospital in Greece, using different growth curves, and it examines the associated nutritional and clinical factors. Fenton2013 and INTERGROWTH-21st growth curves were used to calculate z-scores of birth weight (BW) and weight, length, and head circumference at discharge. The study includes 462 newborns with a mean BW of 1341.5 g and mean GA of 29.6 weeks. At birth, 6.3% of neonates were classified as SGA based on Fenton2013 curves compared to 9.3% with INTERGROWTH-21st growth curves. At discharge, 45.9% of neonates were characterized as having EUGR based on the Fenton2013 weight curves and 29.2% were characterized based οn INTERGROWTH-21st curves. Nutritional factors such as the day of initiation, attainment of full enteral feeding, and the duration of parenteral nutrition were associated with EUGR by both curves. The prevalence of SGA and EUGR neonates differs between the two growth references. This shows that further evaluation of these charts is needed to determine the most appropriate way to monitor infant growth. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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12 pages, 716 KiB

Open AccessArticle

Growth and Duration of Inflammation Determine Short- and Long-Term Outcome in Very-Low-Birth-Weight Infants Requiring Abdominal Surgery

by Corinna Peter, Abdulmonem Abukhris, Julia Brendel, Carolin Böhne, Bettina Bohnhorst and Sabine Pirr

Nutrients 2023, 15(7), 1668; https://doi.org/10.3390/nu15071668 - 29 Mar 2023

Cited by 3 | Viewed by 1568

Abstract

Necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP) and meconium-related ileus (MI) requiring surgical intervention are associated with a high risk of severe short- and long-term complications in very-low-birth-weight (VLBW) infants including poor growth, cholestasis and neurodevelopmental impairment. This retrospective study aimed to identify [...] Read more.

Necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP) and meconium-related ileus (MI) requiring surgical intervention are associated with a high risk of severe short- and long-term complications in very-low-birth-weight (VLBW) infants including poor growth, cholestasis and neurodevelopmental impairment. This retrospective study aimed to identify risk factors for such complications in a cohort of 55 VLBW preterm infants requiring surgery with enterostomy creation due to NEC, SIP or MI. Long-term follow-up was available for 43 (78%) infants. Multiple regression analyses revealed that the duration of inflammation and longitudinal growth determined the risk of cholestasis and neurodevelopmental outcome at 2 years corrected age independent of the aetiology of the intestinal complication. Direct bilirubin increased by 4.9 μmol/L (95%CI 0.26–9.5), 1.4 μmol/L (95%CI 0.6–2.2) and 0.8 μmol/L (95%CI 0.22–1.13) with every day of elevated (Interleukin-6) IL-6, (C-reactive protein) CrP and parenteral nutrition. The mental development index at 2 years corrected age decreased by 3.8 (95%CI −7.3–−0.36), 0.4 (95%CI 0.07–0.80) and 0.3 (95%CI 0.08–0.57) with every day of elevated IL-6 and every 1 point decrease in weight percentile at discharge and 2 years. These data stress the importance of optimal timing for the initial surgery in order to prevent prolonged inflammation and an early reversal of the enterostomy in case of poor growth or insufficient enteral nutrition. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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13 pages, 890 KiB

Open AccessArticle

Early-Life Slow Enteral Feeding Progression Pattern Is Associated with Longitudinal Head-Size Growth Faltering and Neurodevelopmental Impairment Outcomes in Extremely Preterm Infants

by Yung-Chieh Lin, Chi-Hsiang Chu, Yen-Ju Chen, Ray-Bing Chen and Chao-Ching Huang

Nutrients 2023, 15(5), 1277; https://doi.org/10.3390/nu15051277 - 4 Mar 2023

Viewed by 2253

Abstract

Objective: To determine whether feeding progression patterns in the first eight postnatal weeks, depicted by clustering analysis of daily enteral feeding volume, are associated with longitudinal head-circumference (HC) growth and neurodevelopmental outcomes in extremely preterm (EP) infants. Methods: 200 infants who were admitted [...] Read more.

Objective: To determine whether feeding progression patterns in the first eight postnatal weeks, depicted by clustering analysis of daily enteral feeding volume, are associated with longitudinal head-circumference (HC) growth and neurodevelopmental outcomes in extremely preterm (EP) infants. Methods: 200 infants who were admitted at gestational ages 23–27 weeks between 2011 and 2018; survived to discharge; and underwent longitudinal HC growth measurements at birth, term-equivalent age (TEA), corrected age (CA) 6-month, 12-month, and 24-month; and neurodevelopmental assessment using the Bayley Scales of Infant Development at CA 24 months were included for analysis. Results: kmlShape analysis identified two distinct enteral feeding progression patterns: fast progression in 131 (66%) infants and slow progression in 69 (34%) infants. Compared to the fast progression group, the slow progression group showed significantly lower daily enteral volumes after day 13, was older in postnatal age reaching full feeding, had a higher rate of Delta z scores of HC (zHC) < −1 (p < 0.001) between birth and TEA, and displayed lower longitudinal zHC from TEA to CA 24 months. The slow progression group also showed higher rates of microcephaly [42% vs. 16%, p < 0.001; adjusted odd ratio (aOR): 3.269, p = 0.001] and neurodevelopmental impairment (NDI) (38% vs. 19%, p = 0.007; aOR: 2.095, p = 0.035) at CA 24 months. For NDI, the model including feeding progression patterns showed a lower Akaike information criterion score and a better goodness of fit than the model that did not include feeding patterns. Conclusion: Characterizing feeding progression pattern may help identify EP infants at high-risk of head-size growth faltering and NDI at early childhood. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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15 pages, 657 KiB

Open AccessArticle

Effect of Targeted vs. Standard Fortification of Breast Milk on Growth and Development of Preterm Infants (≤32 Weeks): Results from an Interrupted Randomized Controlled Trial

by Joanna Seliga-Siwecka, Justyna Fiałkowska and Anna Chmielewska

Nutrients 2023, 15(3), 619; https://doi.org/10.3390/nu15030619 - 25 Jan 2023

Cited by 2 | Viewed by 3125

Abstract

Human milk is recommended for very low birth weight infants. Their nutritional needs are high, and the fortification of human milk is a standard procedure to optimize growth. Targeted fortification accounts for the variability in human milk composition. It has been a promising [...] Read more.

Human milk is recommended for very low birth weight infants. Their nutritional needs are high, and the fortification of human milk is a standard procedure to optimize growth. Targeted fortification accounts for the variability in human milk composition. It has been a promising alternative to standard fixed-dose fortification, potentially improving short-term growth. In this trial, preterm infants (≤32 weeks of gestation) were randomized to receive human milk after standard fortification (HMF, Nutricia) or tailored fortification with modular components of proteins (Bebilon Bialko, Nutricia), carbohydrates (Polycal, Nutricia), and lipids (Calogen, Nutricia). The intervention started when preterms reached 80 mL/kg/day enteral feeds. Of the target number of 220 newborns, 39 were randomized. The trial was interrupted due to serious intolerance in five cases. There was no significant difference in velocity of weight gain during the supplementation period (primary outcome) in the tailored vs. standard fortification group: 27.01 ± 10.19 g/d vs. 25.84 ± 13.45 g/d, p = 0.0776. Length and head circumference were not significantly different between the groups. We found the feasibility of targeted fortification to be limited in neonatal intensive care unit practice. The trial was registered at clinicaltrials.gov NCT:03775785. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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12 pages, 906 KiB

Open AccessArticle

Supplementation of Mother’s Own Milk with Preterm Donor Human Milk: Impact on Protein Intake and Growth in Very Low Birth Weight Infants—A Randomized Controlled Study

by Giannoula Gialeli, Anastasia Kapetanaki, Ourania Panagopoulou, Panagiota Vourna, Athanasios Michos, Christina Kanaka-Gantenbein, George Liosis and Tania Siahanidou

Nutrients 2023, 15(3), 566; https://doi.org/10.3390/nu15030566 - 21 Jan 2023

Cited by 1 | Viewed by 3254

Abstract

This randomized study investigates whether feeding very low birth weight (VLBW) infants with mother’s own milk (MOM) supplemented with either preterm (PDM) or term donor milk (TDM), when MOM is insufficient, has a positive impact on infants’ protein intake and growth. A hundred [...] Read more.

This randomized study investigates whether feeding very low birth weight (VLBW) infants with mother’s own milk (MOM) supplemented with either preterm (PDM) or term donor milk (TDM), when MOM is insufficient, has a positive impact on infants’ protein intake and growth. A hundred and twenty VLBW infants were randomized into two groups. Group A (43 infants) received MOM supplemented with PDM, whereas Group B (77 infants) was fed with MOM supplemented with TDM, for the first three weeks of life (donor milk period). Breast milk fortifier was added when milk feeds exceeded 50 mL/Kg/day. After the donor milk period, both groups were fed with formula when MOM was not available or the milk bank was unable to provide TDM. Protein intake was higher in Group A than in Group B at initiation of milk fortification (p = 0.006), as well as during the 3-week donor milk period (p = 0.023) and throughout hospitalization (p = 0.014). Moreover, Group A presented higher Δz-score for body weight (p = 0.019) and head circumference (p = 0.001) from birth to the end of donor milk period, and higher mean body weight at discharge (p = 0.047) compared to Group B. In conclusion, when donor milk is required, PDM positively impacts protein intake and growth in VLBW infants (NCT05675397). Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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12 pages, 758 KiB

Open AccessArticle

Muscle Function, Body Composition, Insulin Sensitivity and Physical Activity in Adolescents Born Preterm: Impact of Gestation and Vitamin D Status

by Claire L. Wood, Robert Tinnion, Kieren G. Hollingsworth, Michael I. Trenell, Mark S. Pearce, Tim D. Cheetham and Nicholas D. Embleton

Nutrients 2022, 14(23), 5045; https://doi.org/10.3390/nu14235045 - 27 Nov 2022

Cited by 2 | Viewed by 2751

Abstract

Whilst several studies have explored adolescent metabolic and cognitive function after preterm birth, few have explored muscle function and physical activity. We set out to examine the relationship between gestational age and muscle metabolism in a cohort of adolescents who were born preterm. [...] Read more.

Whilst several studies have explored adolescent metabolic and cognitive function after preterm birth, few have explored muscle function and physical activity. We set out to examine the relationship between gestational age and muscle metabolism in a cohort of adolescents who were born preterm. Participants were recruited from the Newcastle preterm birth growth study cohort. They did not have severe neurological disease and were not on daily medication. Participants underwent an assessment of oxidative muscle function using phosphorus magnetic resonance spectroscopy that included the half-time for recovery of equilibrium of phosphocreatine, τ_½PCr. In addition, we measured key variables that might affect muscle function including physical activity levels determined by 3-day accelerometry, body composition using air displacement plethysmography, insulin sensitivity using the homeostatic model assessment/Matsuda index and serum vitamin D concentrations. 60 adolescents (35F) median age 15.6 years (range 12.1–18.8) with a median gestation of 31 weeks (range 24 to 34 weeks) underwent a single assessment. Males were more active and spent less time in sedentary mode. Time spent in light activity was associated with insulin sensitivity (IS) (Matsuda Index; p < 0.05) but there were no strong correlations between activity levels and gestational age. Greater fat mass, waist circumference and body mass index were all associated with lower IS. Gestational age was negatively associated with adjusted measures of oxidative muscle function (τ_½PCr). In a stepwise multivariate linear regression model, gestational age at birth was the most significant predictor of oxidative muscle function (p = 0.005). Higher serum vitamin D levels were also associated with faster phosphocreatine recovery time (p = 0.045). Oxidative function in the skeletal muscle of adolescents born preterm is associated with gestational age and vitamin D concentrations. Our study suggests that being born preterm may have a long-term impact on muscle metabolism. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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15 pages, 1009 KiB

Open AccessArticle

Breastfeeding in Neonates Admitted to an NICU: 18-Month Follow-Up

by Rozeta Sokou, Stavroula Parastatidou, Georgios Ioakeimidis, Evangelia-Filothei Tavoulari, Athanasia Makrogianni, Elina Isaakidou, Nicoletta Iacovidou and Aikaterini Konstantinidi

Nutrients 2022, 14(18), 3841; https://doi.org/10.3390/nu14183841 - 16 Sep 2022

Cited by 6 | Viewed by 4500

Abstract

Introduction: The admission of neonates to Neonatal Intensive Care Units (NICUs) has been identified as a primary inhibiting factor in the establishment of breastfeeding. The aims of this study were to (1) estimate the prevalence and duration of breastfeeding in infants/toddlers who had [...] Read more.

Introduction: The admission of neonates to Neonatal Intensive Care Units (NICUs) has been identified as a primary inhibiting factor in the establishment of breastfeeding. The aims of this study were to (1) estimate the prevalence and duration of breastfeeding in infants/toddlers who had been admitted to an NICU in Greece and (2) to investigate factors, associated with the NICU stay, which affected the establishment and maintenance of breastfeeding in infants/toddlers previously admitted to the NICU. Materials and methods: Data for this cohort study were retrieved from interviews with mothers of infants/toddlers who had been admitted to our NICU as neonates during the period of 2017–2019. Interviews were conducted based on a questionnaire regarding the child’s nutrition from birth to the day of the interview, including previous maternal experience with breastfeeding. Information related to the prenatal period, gestation age, delivery mode, duration of NICU stay, and neonatal feeding strategies during their hospital stay were recorded. Results: The response rate to the telephone interviews was 57%, resulting in 279 mother–infant pairs being included in this study. The results showed that 78.1% of children received maternal milk during their first days of life. Of all infants, 58.1% were exclusively breastfed during their first month, with a gradual decrease to 36.9% and 19.4% by the end of the third and sixth months of life, respectively. The prevalence of breastfed children reached 14.7% and 7.5% at the ages of twelve and eighteen months, respectively. In the multivariate analysis, prematurity emerged as an independent prognostic factor for the duration of exclusive and any breastfeeding (aHR 1.64, 95% CI: 1.03–2.62; and 1.69, 95% CI: 1.05–2.72, respectively; p < 0.05). Additionally, the nationality of the mother, NICU breastfeeding experience, the administration of maternal milk during neonatal hospital stay, and previous breastfeeding experience of the mother were independent prognostic factors for the duration of breastfeeding. Conclusions: Although breastfeeding is a top priority in our NICU, the exclusive-breastfeeding rates at 6 months were quite low for the hospitalized neonates, not reaching World Health Organization (WHO) recommendations. Mothers/families of hospitalized neonates should receive integrated psychological and practical breastfeeding support and guidance. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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Review

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12 pages, 292 KiB

Open AccessReview

An Update on Lung Function of Extremely and Very Preterm Infants in Later Life: The Role of Early Nutritional Interventions

by Despina D. Briana and Ariadne Malamitsi-Puchner

Nutrients 2023, 15(15), 3353; https://doi.org/10.3390/nu15153353 - 28 Jul 2023

Cited by 1 | Viewed by 1858

Abstract

Birth occurring at ≤32 weeks’ gestation (“very preterm”) or at ≤28 weeks’ gestation (“extremely preterm”) potentially poses considerable health problems for the neonate, including respiratory sequelae, not only during the immediate newborn period, but throughout childhood and into adulthood. With the progressive improvements [...] Read more.

Birth occurring at ≤32 weeks’ gestation (“very preterm”) or at ≤28 weeks’ gestation (“extremely preterm”) potentially poses considerable health problems for the neonate, including respiratory sequelae, not only during the immediate newborn period, but throughout childhood and into adulthood. With the progressive improvements in neonatal care, the survival of extremely preterm and very preterm neonates has improved substantially. However, a considerable percentage of these infants suffer dysfunctions that may trigger, at some stage later in life, the onset of respiratory morbidities. The interruption of the normal development of the respiratory tract caused by preterm birth, in combination with postnatal lung injury caused by various interventions, e.g., mechanical ventilation and oxygen therapy, increases the risk ofthe development of long-term respiratory deficits in survivors. Those infants that are most affected are those who develop chronic lung disease of prematurity (also called bronchopulmonary dysplasia, BPD), but impaired lung function can develop irrespective of BPD diagnosis. Apart from indicating abnormal lung function in survivors of extreme prematurity, recent long-term follow-up studies also emphasize the crucial role of early nutritional intake as an effective strategy, which promotes lung growth and repair. This article will update the associations between extremely/very preterm birth with long-term respiratory outcomes. It will also discuss the protective effect of nutritional interventions, focusing on recently published follow-up data. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

21 pages, 808 KiB

Open AccessReview

Knowledge Gaps and Current Evidence Regarding Breastfeeding Issues in Mothers with Chronic Diseases

by Rozeta Sokou, Stavroula Parastatidou, Zoi Iliodromiti, Katerina Lampropoulou, Dionysios Vrachnis, Theodora Boutsikou, Aikaterini Konstantinidi and Nicoletta Iacovidou

Nutrients 2023, 15(13), 2822; https://doi.org/10.3390/nu15132822 - 21 Jun 2023

Cited by 3 | Viewed by 3544

Abstract

The prevalence of chronic maternal disease is rising in the last decades in the developed world. Recent evidence indicated that the incidence of chronic maternal disease ranges from 10 to 30% of pregnancies worldwide. Several epidemiological studies in mothers with chronic diseases have [...] Read more.

The prevalence of chronic maternal disease is rising in the last decades in the developed world. Recent evidence indicated that the incidence of chronic maternal disease ranges from 10 to 30% of pregnancies worldwide. Several epidemiological studies in mothers with chronic diseases have mainly focused on the risk for adverse obstetric outcomes. Evidence from these studies supports a correlation between maternal chronic conditions and adverse perinatal outcomes, including increased risk for preeclampsia, cesarean section, preterm birth, and admission in the Neonatal Intensive Care Unit (NICU). However, there is a knowledge gap pertaining to the management of these women during lactation. This review aimed at summarizing the available research literature regarding breastfeeding in mothers with chronic diseases. Adjusted and evidence-based support may be required to promote breastfeeding in women with chronic diseases; however, our comprehension of breastfeeding in this subpopulation is still unclear. The literature related to breastfeeding extends in various scientific areas and multidisciplinary effort is necessary to compile an overview of current evidence and knowledge regarding breastfeeding issues in mothers with chronic diseases. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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11 pages, 590 KiB

Open AccessReview

Classification and Special Nutritional Needs of SGA Infants and Neonates of Multiple Pregnancies

by Chrysoula Kosmeri, Vasileios Giapros, Dimitrios Rallis, Foteini Balomenou, Anastasios Serbis and Maria Baltogianni

Nutrients 2023, 15(12), 2736; https://doi.org/10.3390/nu15122736 - 13 Jun 2023

Cited by 5 | Viewed by 3378

Abstract

Data regarding the nutritional management of preterm small for gestational age (SGA) infants are scarce. In the recent report of ESPGHAN, the recommended energy for very preterm infants during hospitalization has been increased, yet this may not fit the needs of all preterm [...] Read more.

Data regarding the nutritional management of preterm small for gestational age (SGA) infants are scarce. In the recent report of ESPGHAN, the recommended energy for very preterm infants during hospitalization has been increased, yet this may not fit the needs of all preterm infants. It is important to distinguish fetal growth-restricted (FGR) infants from constitutional SGA infants, as well as preterm SGA from preterm AGA infants, since they may have different nutritional needs. Preterm FGR infants, and specifically infants < 29 weeks’ gestation, accumulate nutrient deficits due to intrauterine malnutrition, prematurity, morbidities, delayed initiation of feeding, and feeding intolerance. Therefore, these infants may need more aggressive nutrition for optimal catch-up growth and neurologic development. However, a balance should be kept between optimal and excessive catch-up growth, since the combination of intrauterine malnutrition and excessive postnatal growth has been linked with later adverse metabolic consequences. Furthermore, multiple gestation is often complicated by FGR and prematurity. There is controversy in the definition of FGR in multiple gestations, and it should be noted that FGR in multiple gestation usually differs etiologically from FGR in singletons. The aim of this review is to summarize existing knowledge regarding the nutritional needs of preterm FGR and FGR infants of multiple gestation. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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11 pages, 269 KiB

Open AccessReview

Nutrition of Infants with Bronchopulmonary Dysplasia before and after Discharge from the Neonatal Intensive Care Unit

by Ageliki A. Karatza, Despoina Gkentzi and Anastasia Varvarigou

Nutrients 2022, 14(16), 3311; https://doi.org/10.3390/nu14163311 - 12 Aug 2022

Cited by 16 | Viewed by 3758

Abstract

Bronchopulmonary dysplasia (BPD) represents a severe sequela in neonates born very prematurely. The provision of adequate nutritional support in this high-risk population is challenging. The development of the lungs and physical growth are closely linked together in infants with BPD. Growth deficiency has [...] Read more.

Bronchopulmonary dysplasia (BPD) represents a severe sequela in neonates born very prematurely. The provision of adequate nutritional support in this high-risk population is challenging. The development of the lungs and physical growth are closely linked together in infants with BPD. Growth deficiency has been associated with pulmonary dysfunction, whereas improvement in respiratory status results in growth acceleration. Currently, there is not enough data regarding optimal nutritional strategies in this population. Nutrition in these infants should provide sufficient calories and nutrients to establish growth, avoid growth retardation and assist alveolarization of the lungs. Meticulous follow-up is mandatory during and after discharge from the Neonatal Intensive care Unit (NICU) to minimize growth retardation and improve lung function. Despite the significant literature supporting the contribution of growth and nutrition in the avoidance of BPD, there is limited research regarding interventions and management of infants with established BPD. Our aim was to review clinical strategies applied in everyday clinical practice and identify debates on the nutritional approach of newborns with BPD. Well-organized interventions and clinical trials regarding the somatic development and nutrition of infants with BPD are warranted. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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Other

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8 pages, 1017 KiB

Open AccessOpinion

Extrauterine Growth Restriction and Optimal Growth of Very Preterm Neonates: State of the Art

by Antonios K. Gounaris, Rozeta Sokou, Eleni A. Gounari, Polytimi Panagiotounakou and Ioanna N. Grivea

Nutrients 2023, 15(14), 3231; https://doi.org/10.3390/nu15143231 - 21 Jul 2023

Cited by 10 | Viewed by 2032

Abstract

Over the last few decades, there has been an ongoing debate over both the optimal feeding mode for very premature neonates (VPN) as well as what their optimal growth should be. Despite the American Academy of Pediatric declaring since 1997 that the growth [...] Read more.

Over the last few decades, there has been an ongoing debate over both the optimal feeding mode for very premature neonates (VPN) as well as what their optimal growth should be. Despite the American Academy of Pediatric declaring since 1997 that the growth of VPN should follow the trajectory of intrauterine fetal growth, differences of opinion persist, feeding policies keep changing, and the growth and development of VPN remains extremely variable not only between countries, but even between neighboring neonatal units. Even the appropriate terminology to express poor postnatal growth (extrauterine growth restriction (EGR) and postnatal growth failure (PGF)) remains a subject of ongoing discussion. A number of recent publications have shown that by implementing breast milk fortification and closely following growth and adjusting nutrition accordingly, as per the consensus guidelines of the major Neonatal Societies, we could achieve growth that closely follows birth centiles. A recent position paper from EPSGAN recommending targeted nutritional support to cover the energy and protein deficits sustained by VPN during periods of critical illness further strengthens the above findings. Conclusion: We can promote better growth of VPN by ensuring a stable administration of sufficient calories and protein, especially in the first 2 weeks of life, implementing breast milk fortification, covering energy and protein deficits due to critical illness, and increasing feeding volumes as per the latest guidelines. The adoption of universal protocol for nutrition and growth of VPN is essential and will enable better monitoring of long-term outcomes for this population. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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35 pages, 866 KiB

Open AccessSystematic Review

Anti-SARS-CoV-2 Immunoglobulins in Human Milk after Coronavirus Disease or Vaccination—Time Frame and Duration of Detection in Human Milk and Factors That Affect Their Titers: A Systematic Review

by Margarita Dimitroglou, Rozeta Sokou, Nicoletta Iacovidou, Abraham Pouliakis, Georgios Kafalidis, Theodora Boutsikou and Zoi Iliodromiti

Nutrients 2023, 15(8), 1905; https://doi.org/10.3390/nu15081905 - 14 Apr 2023

Cited by 2 | Viewed by 2031

Abstract

Human milk (HM) of mothers infected with or vaccinated against SARS-CoV-2 contains specific immunoglobulins, which may protect their offspring against infection or severe disease. The time frame and duration after infection or vaccination, during which these immunoglobulins are detected in HM, as well [...] Read more.

Human milk (HM) of mothers infected with or vaccinated against SARS-CoV-2 contains specific immunoglobulins, which may protect their offspring against infection or severe disease. The time frame and duration after infection or vaccination, during which these immunoglobulins are detected in HM, as well as the major factors that influence their levels, have not been fully elucidated. This systematic review aimed to collect the existing literature and describe the immune response, specifically regarding the immunoglobulins in HM after COVID-19 disease or vaccination in non-immune women. We conducted a systematic search of PubMed and Scopus databases to identify studies published up until 19 March 2023. In total, 975 articles were screened, and out of which 75 were identified as being relevant and were finally included in this review. Infection by SARS-CoV-2 virus primarily induces an IgA immune response in HM, while vaccination predominantly elevates IgG levels. These immunoglobulins give HM a neutralizing capacity against SARS-CoV-2, highlighting the importance of breastfeeding during the pandemic. The mode of immune acquisition (infection or vaccination) and immunoglobulin levels in maternal serum are factors that seem to influence immunoglobulin levels in HM. Further studies are required to determine the impact of other factors, such as infection severity, lactation period, parity, maternal age and BMI on immunoglobulin level in HM. Full article

(This article belongs to the Special Issue Nutrition and Growth of Preterm Neonates during Hospitalization: Impact on Childhood Outcomes)

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