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Nutrients
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Nutritional Assessment and Clinical Care of Premature Infant
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Nutritional Assessment and Clinical Care of Premature Infant

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition Methodology & Assessment".

Deadline for manuscript submissions: closed (16 April 2023) | Viewed by 9043

Special Issue Editor

Dr. Yanna Zhu

E-Mail Website
Guest Editor
Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
Interests: nutritional disorders (obesity/metabolic syndrome/anemia); nutritional assessment and intervention; inflammation; intestinal bacteria; maternal and child health

Special Issue Information

Dear Colleagues,

The rate of premature infants (GA < 37week) around the world has rapidly increased in recent years, accounting for 5–18% of newborns. Most of these preterm subjects are born with a premature or fragile gastrointestinal system, and typically encounter feeding intolerance and other feeding difficulties, possibly leading to undernutrition, infections, gut disorders and brain defects. Thus, it is important to screen and assess nutritional disorders as early as possible and provide proper feeding strategies for doctors and health workers to prevent premature infants from experiencing adverse clinical consequences.

At present, various nutritional assessment approaches have been applied in health care and clinical treatments among adult inpatients—nutritional assessment scales, nutritional surveys, anthropometric measures and evaluation of energy requirements. However, most approaches for children, especially for premature infants, are still under-researched due to a lack of established methodology, such as screening scales/tools for nutritional risk. Meanwhile, since they are highly threatened by critical disorders, premature infants are confronted with complicated feeding practices including selection of parenteral or enteral nutrition, optimal time to full enteral feeding, donor milk or formula feeding, fortification of breast milk, vitamin D and iron supplements as well as pre- and probiotics application. Therefore, identifying appropriate strategies to assess nutritional status and feeding practices for premature infants and evaluating the association of these strategies with clinical outcomes, including diseases, growth and neurodevelopment, are crucial.

The scope of this Special Issue will be broad, and possible topics of interest include but are not limited to:

  • Methodologies for nutritional surveys, nutritional risk screening and malnutrition assessment for premature infants or children born premature
  • Evaluation of the effects and influencing factors of nutritional risk screening or malnutrition assessment on hospitalized premature infants
  • Comparison of the effects of different nutritional assessment methodologies on clinical outcomes in premature infants
  • Association of nutritional risk and malnutrition with catch-up growth, motor development and neurocognitive function in premature infants
  • Evaluation of the effects of different feeding strategies for premature infants on clinical outcomes
  • Assessment of the effects of fortification of breast milk, nutrient supplementation and pre- and probiotics application on diseases, growth and neurodevelopment for premature infants or children born premature

We hope that the papers included in this Special Issue will share new information about methodologies for nutritional assessment, feeding practices and their association with clinical outcomes and health care, and provide more evidence to improve feeding guidelines for premature infants in the future.

Dr. Yanna Zhu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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Published Papers (3 papers)

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Research

14 pages, 909 KiB  
Article
A Randomized, Controlled Study to Investigate How Bovine Colostrum Fortification of Human Milk Affects Bowel Habits in Preterm Infants (FortiColos Study)
by Susanne Soendergaard Kappel, Per Torp Sangild, Agnethe May Ahnfeldt, Valdis Jóhannsdóttir, Line Juul Soernsen, Lene Boejgaard Bak, Christel Friborg, Sören Möller, Gitte Zachariassen and Lise Aunsholt
Nutrients 2022, 14(22), 4756; https://doi.org/10.3390/nu14224756 - 10 Nov 2022
Cited by 13 | Viewed by 2797
Abstract
Background: Human milk does not meet the nutritional needs to support optimal growth of very preterm infants during the first weeks of life. Nutrient fortifiers are therefore added to human milk, though these products are suspected to increase gut dysmotility. The objective was [...] Read more.
Background: Human milk does not meet the nutritional needs to support optimal growth of very preterm infants during the first weeks of life. Nutrient fortifiers are therefore added to human milk, though these products are suspected to increase gut dysmotility. The objective was to evaluate whether fortification with bovine colostrum (BC) improves bowel habits compared to a conventional fortifier (CF) in very preterm infants. Methods: In an unblinded, randomized study, 242 preterm infants (26–31 weeks of gestation) were randomized to receive BC (BC, Biofiber Damino, Gesten, Denmark) or CF (FM85 PreNAN, Nestlé, Vevey, Switzerland) as a fortifier. Stools (Amsterdam Stool Scale), bowel gas restlessness, stomach appearance score, volume, and frequency of gastric residuals were recorded before each meal until 35 weeks post-menstrual age. Results: As intake of fortifiers increased, stools became harder in both groups (p < 0.01) though less in BC infants (p < 0.05). The incidence of bowel gas restlessness increased with laxative treatments and days of fortification in both groups (p < 0.01), but laxatives were prescribed later in BC infants (p < 0.01). With advancing age, stomach appearance scores improved, but more so in BC infants (p < 0.01). Conclusions: Although there are limitations, a minimally processed, bioactive milk product such as BC induced similar or slightly improved bowel habits in preterm infants. Full article
(This article belongs to the Special Issue Nutritional Assessment and Clinical Care of Premature Infant)
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10 pages, 1113 KiB  
Article
Incidence, Risk Factors and Prediction of Secondary Hyperparathyroidism in Preterm Neonates under 32 Weeks’ Gestational Age
by Alejandro Avila-Alvarez, Helena Perez Tato, Andrea Sucasas Alonso, Ana Prado Carro and Jesus Fuentes Carballal
Nutrients 2022, 14(16), 3397; https://doi.org/10.3390/nu14163397 - 18 Aug 2022
Cited by 3 | Viewed by 2320
Abstract
In preterm newborns, secondary hyperparathyroidism (HPTH) is an underdiagnosed and undertreated entity. Its detection in the context of metabolic bone mineral disease (MBD) screening programs may be important to guide nutritional treatment. We designed a retrospective cohort study to determine the incidence of [...] Read more.
In preterm newborns, secondary hyperparathyroidism (HPTH) is an underdiagnosed and undertreated entity. Its detection in the context of metabolic bone mineral disease (MBD) screening programs may be important to guide nutritional treatment. We designed a retrospective cohort study to determine the incidence of HPTH in very premature infants. As secondary objectives, we studied the risk factors, morbidities, and biochemical alterations associated with HPTH. A total of 154 preterm newborns ≤32 weeks gestational age (GA) were included. Of these, 40.3% (n = 62) presented with HPTH. In the multivariate analysis, independent risk factors for HPTH were cesarean section (OR: 4.00; 95% CI: 1.59–10.06), oxygen during resuscitation (OR: 3.43; 95% CI: 1.09–10.81), invasive mechanical ventilation (OR: 3.56; 95% CI: 1.63–7.77) and anemia requiring transfusion (OR: 2.37; 95% CI: 1.01–5.57). Among the analytical variables, serum calcium (OR: 0.53; 95% CI: 0.29–0.97), serum phosphate (OR: 2.01; 95% CI: 1.39–2.92), vitamin D (OR: 0.96; 95% CI: 0.93–1), and the calcium/creatinine ratio in urine (OR: 0.05; 95% CI: 0.01–0.28) were independently associated with HPTH. The simplified predictive model included GA and calcium/creatinine ratio in urine and demonstrated an AUC of 0.828. We concluded that HPTH is a frequent entity among very premature infants and that further studies are required to determine the role of HPTH in MBD and the clinical applicability of prediction models. Full article
(This article belongs to the Special Issue Nutritional Assessment and Clinical Care of Premature Infant)
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13 pages, 19740 KiB  
Article
Establishing Postnatal Growth Monitoring Curves of Preterm Infants in China: Allowing for Continuous Use from 24 Weeks of Preterm Birth to 50 Weeks
by Xin’nan Zong, Hui Li and Yaqin Zhang
Nutrients 2022, 14(11), 2232; https://doi.org/10.3390/nu14112232 - 27 May 2022
Cited by 6 | Viewed by 3042
Abstract
Background: Early postnatal growth monitoring and nutrition assessment for preterm infants is a public health and clinical concern. We aimed to establish a set of postnatal growth monitoring curves of preterm infants to better help clinicians make in-hospital and post-discharge nutrition plan of [...] Read more.
Background: Early postnatal growth monitoring and nutrition assessment for preterm infants is a public health and clinical concern. We aimed to establish a set of postnatal growth monitoring curves of preterm infants to better help clinicians make in-hospital and post-discharge nutrition plan of these vulnerable infants. Methods: We collected weight, length and head circumference data from a nationwide survey in China between 2015 and 2018. Polynomial regression and the modified LMS methods were employed to construct the smoothed weight, length and head circumference growth curves. Results: We established the P3, P10, P25, P50, P75, P90, P97 reference curves of weight, length and head circumference that allowed for continuous use from 24 weeks of preterm birth to 50 weeks and developed a set of user-friendly growth monitoring charts. We estimated approximate ranges of weight gain per day and length and head circumference gains per week. Conclusions: Our established growth monitoring curves, which can be used continuously without correcting gestational age from 24 weeks of preterm birth to 50 weeks, may be useful for assessment of postnatal growth trajectories, definition of intrauterine growth retardation at birth, and classification of early nutrition status for preterm infants. Full article
(This article belongs to the Special Issue Nutritional Assessment and Clinical Care of Premature Infant)
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