Am J Perinatol 2018; 35(12): 1138-1141
DOI: 10.1055/s-0038-1645859
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Reevaluation of Protein Intake for Preterm Infants

Masahiko Kawai
1   Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
› Author Affiliations
Further Information

Publication History

19 April 2017

20 March 2018

Publication Date:
24 April 2018 (online)

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Abstract

Growth failure caused by undernutrition is considered one of the major causes for psychomotor delay in extremely preterm infants, and the concept for “aggressive nutritional approach” is widely accepted worldwide. Based on this, postnatal early catch-up growth due to sufficient supply of nutrients including sufficient amounts of amino acids is believed to be essential for a better outcome; however, there is no definitive evidence of aggressive nutrition on better outcomes in mortality, growth, and neurodevelopment. On the contrary, epidemiological evidence suggests that low birth weight and a rapid catch-up growth after birth are major risk factors for insulin resistance and diabetes in later life; higher protein intake during postnatal period relates to higher cardiovascular risk in later life. Considering these, optimal nutrition, especially protein administration, should be reevaluated. In this review, current opinions on the nutrition for the preterm infants are surveyed. In addition, I propose a new concept for optimized protein amount for the preterm infants based on the difference of amino acid metabolism between fetuses and preterm infants.