Clinical guidelines for the management of preterm infants

Preterm infants have unique nutritional needs to match their distinct growth and developmental goals. There are several clinical guidelines to support the nutritional management of preterm infants.

ESPGHAN

The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) recommendations from 20101 are the most up-to-date and definitive guidance for the nutritional requirements of preterm infants under 1800g, and are the leading guidelines followed by Nutricia when addressing the nutritional needs of preterm infants. ESPGHAN also provide commentary and guidance for the nutritional needs of preterm born infants once they are discharged from hospital, including nutritional support for those with suboptimal growth2.

European Milk Bank Association

Human milk is acknowledged as the best nutrition for all infants, including preterm infants, however its nutritional composition is not adapted to their specific needs. Human milk provides unique immune protection and developmental outcome benefits but supplies insufficient amounts of a large number of nutrients when fed at the usual preterm volumes – and as such human milk

fortification is addressed in both ESPGHAN commentaries. The European Milk Bank Association also provide a dedicated review and recommendations for human milk fortification in preterm infants3.

ESPGHAN

An ad hoc panel of experts was convened by ESPGHAN to review existing guidelines on enteral feeding of preterm infants (last updated in 1987) and to make appropriate recommendations based on more recent evidence. You can read their report here.

ESPGHAN – post discharge

The ESPGHAN Committee on Nutrition has reviewed the evidence on feeding and monitoring these infants post discharge and have made available a series of recommendations for those who care for them.

European Milk Bank Association

Human milk (HM) is the best possible nutrition for most infants, however preterm infants with very low birth weight may need HM supplementation (fortification) to support growth. The European Milk Bank Association (EMBA) Working Group on HM Fortification have written a set of guidelines and recommendations on this topic.

  1. Agett, P.J. et al. ESPGHAN Committee on Nutrition:. Feeding Preterm Infants After Hospital Discharge: A Commentary by the ESPGHAN Committee on Nutrition. Journal of Pediatric Gastroenterology and Nutrition: May 2006 - Volume 42 - Issue 5 - p 596-603
  2. Agostoni, C. et al. for the ESPGHAN Committee on Nutrition. Enteral Nutrient Supply for Preterm Infants: Commentary From the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. Journal of Pediatric Gastroenterology and Nutrition: January 2010 - Volume 50 - Issue 1 - p 85-91
  3. Arslanoglu S. et al. Fortification of Human Milk for Preterm Infants: Update and Recommendations of the European Milk Bank Association (EMBA) Working Group on Human Milk Fortification. Front. Pediatr., 22 March 2019 Sec. Neonatology

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