Abstract
Preterm low birth weight infants remain at risk of impaired growth and developmental delay in childhood, compared with full-term babies. The main aim of the research project was to devise and test a preterm infant feeding strategy (PIFS) for the time from hospital discharge until one-year gestation corrected age (GCA). The strategy recommended the early onset of weaning, the use of foods with a higher energy and protein content than standard milk formula and recommended foods, which are rich sources of iron and zinc. To assess the effectiveness of the preterm infant feeding strategy, 68 preterm infants, mean birth weight 1.47 (SD 0.43) kg and mean gestational age 31.3 (SD 2.9) weeks, were randomised to either the PIFS group (n=37) or a current best practice control group (n=31), for one year. Energy, protein and mineral intakes at three points, zero months GCA, six months GCA and twelve months GCA, were determined from 7-day weighed records. The infants were assessed anthropometrically at the same ages, and blood sampled twice to discover any differences in growth or nutrient status between the groups, which could be a consequence of dietary intake. Analyses of dietary, growth and biochemical data showed the following significant differences between the PIFS intervention group compared with the control group. Improvements in haemoglobin and serum iron levels at six months GCA; increased intakes of energy, protein and carbohydrate at six months GCA and iron at twelve months GCA; enhanced length growth velocity between zero and twelve months GCA. A significant positive effect of treatment on standard deviation length scores and catch-up length growth was also observed. PIFS significantly influenced dietary intakes with consequent beneficial effects on length growth and iron status. This novel strategy should be adopted as the basis of feeding guidelines for preterm infants after hospital discharge.