Advances in Neonatal and Pediatric Nutrition

Despite the fact that feeding a preterm neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies.In order to match the high rates of nutrient deposition achieved by infants in utero, the nutrient needs are inherently high at this stage of development. In addition, they often have medical conditions that increase their metabolic energy requirements, including hypotension, hypoxia, acidosis, infection, and surgery. Though vigrous nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even chronic lung disease

& retinopathy of prematurity. However, it is also important to avoid rapid advances in feeding, which may result in feeding intolerance or necrotizing enterocolitis (NEC), and to recognize that excess of some nutrients may have toxic effects. There is a great deal of heterogeneity of practice among neonatologists pediatricians regarding feeding VLBW infants. A number

of important questions that needs to be answered with respect to feeding VLBW infants were systematically reviewed in the literature, and critically appraised with the level of evidence. The presentation touches upon trophic feeding, nutritional feeding, fortification, role of DHA, feeding in special circumstances, assessment of feed tolerance using abdominal girth or

gastric residuals, role glycerin enemas etc.