Protein intakes to optimize outcomes for preterm infants

Semin Perinatol. 2019 Nov;43(7):151154. doi: 10.1053/j.semperi.2019.06.002. Epub 2019 Jun 22.

Abstract

Proteins are key structural components of all human cells and are also involved in key physiologic processes through their roles as enzymes, hormones and transport proteins. Protein requirements are substantially higher in preterm infants than those born at term, yet inadequate protein intakes are a common problem on many neonatal units. Very preterm infants (VPT, <32 weeks) commonly receive parenteral amino acid solutions which are typically commenced on admission, and increased over the next few days. Several recent studies have explored differing parenteral amino acid intakes in the first few days, and recommendations have recently been updated. Parenteral nutrition intakes are decreased as enteral feeds are tolerated, but human milk alone will not meet protein needs in most VPT and supplementation or fortification will be required. This review paper considers basic protein and amino acid physiology in the newborn period, and the evidence base for current recommendations.

Keywords: Amino acids; Neonate; Nutrient intakes; Parenteral; Premature; Preterm; Protein.

Publication types

  • Review

MeSH terms

  • Amino Acids
  • Dietary Proteins
  • Energy Intake
  • Food, Fortified
  • Guidelines as Topic
  • Humans
  • Infant Formula / chemistry*
  • Infant Nutritional Physiological Phenomena
  • Infant, Newborn
  • Infant, Premature / growth & development*
  • Infant, Very Low Birth Weight / growth & development*
  • Intensive Care Units, Neonatal*
  • Milk, Human / chemistry*
  • Nutritional Requirements
  • Parenteral Nutrition / methods*

Substances

  • Amino Acids
  • Dietary Proteins