<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>During NICU admission, extra-uterine growth retardation that can affect the neurodevelopmental outcome is a challenging problem in extremely preterm infants. This trial aimed to determine the effect of additional enteral protein supplementation on the growth velocity of the anthropometric parameters.</p>
</sec>
<sec><h3>Method</h3>
<p>In this randomized controlled trial, 77 preterm infants (gestational age ≤33 weeks and birth weight &lt;1500 g) who reached full enteral feeding with either fortified breast milk or preterm formula were included. They were randomized to receive either 4-&lt;5 g/kg/day protein through extra protein supplementation (intervention) or 3-&lt;4 g/kg/day protein. Weight gain, as well as length and head circumference growth, were monitored daily and weekly, respectively. Venous blood gas, blood urea nitrogen (BUN), and albumin levels were checked weekly.</p>
</sec>
<sec><h3>Results</h3>
<p>Five out of 77 participants were excluded due to feeding intolerance. Analyses were conducted on 36 neonates with protein intake of 3.66 ± 0.22 gr/kg/day and 36 with extra protein intake. Baseline characteristics were similar between the groups. An additional protein supply of 0.89 gr/kg/day, resulting in an average protein intake of 4.55 ± 0.18 in the intervention group, increased the postnatal weight gain, linear growth, and head circumference growth (7.98 gr/kg/day, 0.347 cm/week, and 0.38 cm/week, respectively). The albumin levels were significantly increased, but the BUN levels were not significantly increased in the intervention group. None of the patients developed necrotizing enterocolitis or significant acidosis.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>Protein supplementation significantly improves the growth of the anthropometric parameters. An increase in serum albumin and no increase in serum urea can indicate the anabolic effect of extra protein. Protein supplementation can add to routine feeding protocols of VLBW infants without any short-term adverse effect; however, further study for evaluation of long-term complications is needed.</p>
</sec>
</abstract>

Background
During NICU admission, extra-uterine growth retardation that can affect the neurodevelopmental outcome is a challenging problem in extremely preterm infants. This trial aimed to determine the effect of additional enteral protein supplementation on the growth velocity of the anthropometric parameters.

Method
In this randomized controlled trial, 77 preterm infants (gestational age ≤33 weeks and birth weight <1500 g) who reached full enteral feeding with either fortified breast milk or preterm formula were included. They were randomized to receive either 4-<5 g/kg/day protein through extra protein supplementation (intervention) or 3-<4 g/kg/day protein. Weight gain, as well as length and head circumference growth, were monitored daily and weekly, respectively. Venous blood gas, blood urea nitrogen (BUN), and albumin levels were checked weekly.

Results
Five out of 77 participants were excluded due to feeding intolerance. Analyses were conducted on 36 neonates with protein intake of 3.66 ± 0.22 gr/kg/day and 36 with extra protein intake. Baseline characteristics were similar between the groups. An additional protein supply of 0.89 gr/kg/day, resulting in an average protein intake of 4.55 ± 0.18 in the intervention group, increased the postnatal weight gain, linear growth, and head circumference growth (7.98 gr/kg/day, 0.347 cm/week, and 0.38 cm/week, respectively). The albumin levels were significantly increased, but the BUN levels were not significantly increased in the intervention group. None of the patients developed necrotizing enterocolitis or significant acidosis.

Conclusion
Protein supplementation significantly improves the growth of the anthropometric parameters. An increase in serum albumin and no increase in serum urea can indicate the anabolic effect of extra protein. Protein supplementation can add to routine feeding protocols of VLBW infants without any short-term adverse effect; however, further study for evaluation of long-term complications is needed.

The Effect of Oral Protein Supplementation on the Growth of Very Low Birth Weight Preterm Infants Admitted to the Neonatal Intensive Care Unit: A Randomized Clinical Trial

Neonatal Research Center, Department of pediatrics, School of Medicine

Journal of Mother and Child

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
During NICU admission, extra-uterine growth retardation that can affect the neurodevelopmental outcome is a challenging problem in extremely preterm...

The Effect of Oral Protein Supplementation on the Growth of Very Low Birth Weight Preterm Infants Admitted to the Neonatal Intensive Care Unit: A Randomized Clinical Trial

Article Category: Original article

Published Online: Jun 27, 2023

Page range: 21 - 29

Received: Nov 20, 2022

Accepted: Jan 12, 2023

DOI: https://doi.org/10.34763/jmotherandchild.20232701.d-22-00072

Keywords
Protein supplement, Preterm infants, Growth, Nutrition, VLBW

© 2023 Fariba Hemmati et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

The Effect of Oral Protein Supplementation on the Growth of Very Low Birth Weight Preterm Infants Admitted to the Neonatal Intensive Care Unit: A Randomized Clinical Trial

Article Category: Original article

Published Online: Jun 27, 2023

Page range: 21 - 29

Received: Nov 20, 2022

Accepted: Jan 12, 2023

DOI: https://doi.org/10.34763/jmotherandchild.20232701.d-22-00072

KeywordsProtein supplement, Preterm infants, Growth, Nutrition, VLBW

© 2023 Fariba Hemmati et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
Protein supplement, Preterm infants, Growth, Nutrition, VLBW