Growth of very low birth weight infants after increased amino acid and protein administration.

Objective: To assess the impact of a high enteral protein nutrition strategy in human milk-fed very low birth weight (VLBW) infants (<1500 g) on growth during the first 5 weeks of life.

Methods: Weight, length and head circumference of VLBW infants were recorded after introduction of a high protein strategy.

Results: Forty-three infants (median/interquartile range) of gestational age 27+6 weeks (26+0/29+6), birth weight 984 g (675/1130) were included. Parenteral nutrition was administered for 16 (14/18) days and the nutritional intakes achieved target values 4.3 g/kg/day protein (4.0/4.4); 128 kcal/kg/day energy (119/131). Human milk was fortified with 0.5-2.3 g/kg/day protein powder in addition to a fortifier. Near-intrauterine growth was observed: Weight gain from days 8-35: 17.6 g/kg/day (14.9/20.5); head growth from day 1-35: 0.70 cm/week (0.50/0.80); length growth from day 1-35: 1.0 cm/week (0.8/1.2). The total protein intake was shown to have a significant impact on infant's weight gain up to the 35th day of life.

Conclusions: High protein nutrition enables similar to fetal growth weight gain and head growth of VLBW infants during the first 5 weeks of life. These data support recently published ESPGHAN recommendations.