Infant Preterm Nutritional Formulas

What is Infant Preterm Nutritional Formulas

Commercial formulas for preterm infants were developed to meet the unique nutritional needs of the growing, preterm infant.

The composition of infant formulas has evolved over many years, and ongoing research continues to improve their acceptability and nutritional quality.

Human milk serves as a model for the composition of infant formulas, but at present, formulas still cannot precisely duplicate the composition of human milk, which contains hormones, immunologic agents, enzymes, and live cells.

Preterm infant formulas have increased nutrient density and are provided in a more readily digestible and absorptive form compared to standard infant formulas.

The quality and quantity of nutrients are determined from the accretion rates for various nutrients relative to the reference fetus and from clinical and metabolic studies of the development of the gastrointestinal tract, which have defined the efficiency of absorption of nutrients.

Compared to unfortified human milk or standard infant formula, preterm formula contains more calories, protein, sodium, calcium, phosphorus, zinc, copper, and vitamins.

Preterm formulas are available with caloric densities between 20—30 kcal/oz with supplemental iron; some formulas contain low iron. The American Academy of Pediatrics (AAP) recommends the use of iron-fortified infant formulas for all premature infants.

In spite of the higher nutrient content, the osmolality of preterm formulas remains low at 250—320 mOsm/kg water.

Use of infant formula is indicated as: a substitute or supplement for human milk in infants whose mothers who cannot or choose not to breast-feed or not to do so exclusively, a substitute for human milk in infants for whom breast-feeding is medically contraindicated, and a supplement for breast-fed infants who do not gain weight adequately.

Preterm, post-discharge or transitional nutrient-enriched, follow-up formulas are also available.

These milk-based, 22 kcal/oz formulas are designed with enhanced nutrients to be used during the first year of life for infants born prematurely or with low birth weight; they are typically initiated for infants when the weight is approximately 1800—2000 g or 34 weeks gestational age.

Compared with standard infant formulas, they have increased calories and protein and higher concentrations of some vitamins and minerals, particularly calcium, phosphorus, zinc, and vitamins A and D.

Although they have higher nutrients compared with standard infant formulas, they contain lower concentrations of these nutrients compared to preterm formulas.

The AAP states that the decision to use preterm postdischarge formulas should be individualized to optimize the growth of the infant during the first year of life.

Indications

  • complete nutrition
  • nutritional supplementation

Side Effects

Preterm infant formulas are iso-osmolar and are usually well tolerated by the premature infant.

Monitoring Parameters

  • serum electrolytes
  • weight

Contraindications

  • breast-feeding
  • dehydration
  • feeding intolerance
  • galactosemia
  • immunosuppression
  • intravenous administration
  • milk protein hypersensitivity
  • necrotizing enterocolitis
  • phenylketonuria
  • pregnancy
  • renal impairment
  • severe combined immunodeficiency (SCID)
  • soya lecithin hypersensitivity

Interactions

No information is available regarding drug interactions associated with Infant Preterm Nutritional Formulas

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