Presentation Information

Achieving Target Growth in Preterm Infants: The Role of Fortification, Micronutrients, and Monitoring

• Speaker: Kumar Ankur , MBBS, MD (Paediatrics), DNB (Neonatology)
• Presentation Type:
• Duration: 60 Mins
• Credits:

Abstract:

Early nutritional interventions play a key role in survival, growth, and long-term health of preterm neonates, especially those weighing less than 1800 grams. Achieving optimal nutrition during this critical window is not only vital for immediate stabilization but also has profound effects on brain development, body composition, and long-term metabolic outcomes. Mother’s own milk (MOM) remains the gold standard, that reduces necrotising enterocolitis (NEC), sepsis, and chronic lung disease, while promoting neurocognitive development. When MOM is unavailable or insufficient, donor human milk (DHM) serves as the preferred alternative; however, fortification with protein, calcium, and phosphorus is essential to meet fetal accretion targets. Parenteral nutrition is indicated early only in unstable or extremely preterm infants to prevent catabolism, but early transition to enteral feeds is encouraged to promote gut adaptation. Evidence from Cochrane reviews, ESPGHAN guidelines, and recent clinical trials highlights that early, carefully advanced enteral feeding is safe, improves growth velocity, and does not increase the risk of NEC when monitored closely.
Key strategies to achieve target growth include exclusive human milk feeding, timely initiation of fortification, and individualized approaches such as adjustable or targeted fortification based on growth trends and biochemical monitoring. Beyond macronutrients, micronutrients such as iron, zinc, and vitamin D are essential for preventing anemia, rickets, and supporting neurodevelopment. Adequate early protein and energy intake correlate strongly with improved cognitive and motor outcomes.