Key Statements
Essentials of Unit 1
There are 15 million babies born preterm each year and preterm birth rates are rising in most countries around the world.
Advances in ventilatory support, the use of antenatal corticosteroids and postnatal surfactant, and improvements in nutritional support has led to better survival rates of preterm infants at earlier gestational ages.
Complications of preterm birth include infections, pulmonary problems, necrotizing enterocolitis, poor growth and neurodevelopment impairment.
Preterm birth can have a profound impact on child development with consequences throughout their entire lifespan.
Optimized nutritional care of preterm infants can significantly improve short and long-term health outcomes. Nutritional care needs to begin on the first day of life.
Nutrition, growth and neurodevelopment are closely interrelated.
The goal of preterm nutritional care is to allow preterm infants to continue growing as they would have in utero. Preterm infants who grow along intrauterine growth curves have fewer short- and long-term complications of preterm birth.
It is better to support steady growth and development with optimal nutrition than to try to "catch up” after growth faltering has occurred.
Adequate protein and energy are necessary for lean body mass accretion. Too much energy supply may lead to excessive fat deposition, which can contribute to insulin resistance in later life.
Enteral feeds must be started early and advanced steadily.
Feeding human milk to preterm infants has been associated with reduced risks of infections and necrotizing enterocolitis.
Parents of a preterm infant are critical members of the care team. Mothers should be encouraged and assisted to provide breast milk. Skin-to-skin contact confers many health benefits to preterm infants and can be provided by both parents.