Nutritional Needs of Low-Birth-Weight Infants

Optimal nutrition is critical in the management of the ever-increasing number of surviving small premature infants. Although the most appropriate goal of nutrition of the low-birth-weight (LBW) infant is not definitively known, achieving a postnatal growth that approximates the in utero growth of a normal fetus at the same postconception age appears to be the most logical approach at present.’ In uncomplicated cases, growth will usually begin by the second week after birth, after the initial changes in body water distribution have taken place, and after the infant has accommodated in a nonstressful way to the provision of enteral feeds and parenteral supplements. The fetal standards of growth that will be considered here include not only weight and length, but also values for rate of retention of individual nutrients and minerals (Table 1).2 The quality ofpostnatal growth may differ from the quality of fetal growth, depending on the type of milk consumed, eg, ex utero weight gain of a premature infant given formula includes more fat gain than that of a fetus of the same maturity.3