3 rowth Failure in the Preterm Infant : an We Catch Up ? nna

ostnatal growth failure is extremely common in the very low birth weight and extremely low birth eight infant. Recent data from the National Institute of Child and Human Development (NICHD) eonatal Research Network indicates that 16% of extremely low birth weight infants are small for estational age at birth, but by 36 weeks corrected age, 89% have growth failure. Follow-up at 18 to 2 months corrected age shows that 40% still have weights, lengths, and head circumferences less han the 10th percentile. Growth failure is associated with an increased risk of poor neurodevelopental outcome. Inadequate postnatal nutrition is an important factor contributing to growth failure, s most extremely low birth weight infants experience major protein and energy deficits during the eonatal intensive care unit hospitalization, in spite of the fact that nutrition sufficient to support ntrauterine growth rates can generally be provided safely. Aggressive nutritional support —pareneral and enteral— is well tolerated in the extremely low birth weight infant and is effective in mproving growth. Continued provision of appropriate nutrition (premature formula or fortified uman milk) is important throughout the neonatal intensive care unit stay. After discharge, nutrientnriched postdischarge formula should be continued for approximately 9 months post-term. Excluively breast-fed infants require additional supplementation/fortification postdischarge as well. dditional trials are needed to address a number of important questions concerning the role of utrition and growth on ultimate development. 2003 Elsevier Inc. All rights reserved.