Feeding and postnatal growth of preterm infants with intrauterine growth retardation

• Irina I. Ryumina
• E.A. Kirillova
• Marina V. Narogan
• Elena V. Grosheva
• Victor V. Zubkov

Abstract

The problem of nursing and feeding children with intrauterine growth retardation is an current problem of pediatrics in connection with high risks of intolerance to enteral feeding, metabolic disorders, a flat weight scale and postnatal hypotrophy. This group of children is characterized by high requirements for plastic material and revisions of concepts of enteral and parenteral feeding.

The aim of the study was to evaluate the dynamics of mass and body length in premature infants with a delay in intrauterine development during a stay in the neonatal hospital with the calculation of nutrition for the actual body weight.

Material and methods. The study included 227 premature newborns born in V.I. Kulakov Obstetrics, Gynecology and Perinatology Research Center of Ministry of Healthcare of the Russian Federation in the period from December 2013 to June 2015. All children were daily monitored daily allowance for the volume of liquid, proteins, fats, carbohydrates and energy. Weekly anthropometric indicators and their correspondence to post-conceptual age on percentile scales were estimated.

Results and discussion. Children with a delay in intrauterine development require a longer period of parenteral nutrition and a more gentle method of increasing the volume of enteral feeding. When analyzing the frequency of postnatal hypotrophy in a group of premature newborns born at 32 and less than a week of gestation, it was revealed that at the time of discharge from the hospital, 100% of children with intrauterine growth retardation and 25.3% of children corresponding to the gestation period had a body weight deficit at the time of discharge. In newborns with HB of 33-36 weeks, the incidence of postnatal hypotrophy was 90% in children with ESRD and 26.7% in children with the same duration of gestation.

Conclusions. Feeding of premature infants with intrauterine growth retardation should be different from feeding preterm infants who are of gestational age, taking into account the complications inherent in these children, in particular, the high incidence of violations of carbohydrate metabolism and dysfunctions of the gastrointestinal tract. These children need the highest possible allowable doses of protein and energy, calculated on the actual body weight. The urgent problem of premature newborns with intrauterine growth retardation is postnatal hypotrophy, which persists at the time of discharge from the hospital.

Keywords:premature infants, intrauterine growth retardation, feeding, breast milk, parenteral nutrition

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