A review of best evidenced-based enteral and parenteral nutrition support practices for preterm infants born <1,500 grams

Nutrition monitoring must remain a priority for very low birth weight infants who are at high risk for nutritional deficiencies and growth failure. Research demonstrates that as many as 50% of North American infants experience extrauterine growth failure, primarily attributable to inadequate nutrition delivery. Consequently, the purpose of this review is to identify the best enteral and parenteral nutrition management practices for preterm infants born <1,500 grams. Nutrition recommendations set forth for preterm infants by leading references were reviewed and compared. Infant nutrition and growth studies identified by extensive literature review were also assessed in comparison to current recommendations, neonatal clinical experience, and gaps within clinical practice. Modern literature demonstrates that more aggressive parenteral nutrition provision, early enteral feeding initiation, more rapid enteral feeding advancement, and early human milk fortification are well tolerated and promote improved nutrition, growth, and clinical outcomes. This review identifies clinically feasible and evidenced-based enteral and parenteral nutrition support practices that promote best outcomes for very low birth weight infants.