Gastrointestinal and feeding issues for infants <25 weeks of gestation |
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| Affiliation: | 1. Department of Obstetrics, LUMC, Albinusdreef 2, Leiden ZA 2333, the Netherlands;2. Department of Obstetrics and Gynaecology, Erasmus MC, the Netherlands;3. Department of Neonatology, Erasmus MC, the Netherlands;4. Department of Medical Ethics, Philosophy and History of Medicine, Erasmus MC, the Netherlands;5. Department of Neonatology, Radboud University Medical Centre, Amalia Children''s Hospital, the Netherlands;6. Department of Paediatrics, University Medical Centre Groningen, University of Groningen, the Netherlands;1. UCL Elizabeth Garrett Anderson Institute for Women''s Health, University College London, 74 Huntley Street, London WC1E 6AU, UK;2. Getting it Right First Tim (GIRFT) Clinical Lead for Neonatology and Consultant Neonatologist, Oxford University Hospitals NHS Foundation Trust, Oxford, UK;1. Neonatal Medicine, Royal Children''s Hospital, 50 Flemington Rd, Victoria, Melbourne, Australia;2. Murdoch Children''s Research Institute, Victoria, Melbourne, Australia;3. Department of Paediatrics, University of Melbourne, Victoria, Australia;4. Melbourne School of Population and Global Health, University of Melbourne, Victoria, Melbourne, Australia;5. Children''s Bioethics Centre, Royal Children''s Hospital, Victoria, Melbourne, Australia;6. Women''s Newborn Research Centre, Royal Women''s Hospital, Victoria, Melbourne, Australia;7. Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Melbourne, Australia;8. Department of Pediatrics, Division of Neonatology, Clinical Ethics Unit, Palliative Care Unit, Unité de Recherche en Éthique Clinique et Partenariat Famille, CHU Ste-Justine, Québec, Montréal, Canada;9. Department of Pediatrics and Clinical Ethics, Université de Montréal, Québec, Montréal, Canada;1. Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, Chicago, IL, 60612, United States of America;2. Department of Pediatrics, University of Illinois at Chicago College of Medicine, Chicago, IL, 60612, United States of America |
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| Abstract: | ![]()
Appropriate nutrition is essential for optimal development and growth of preterm infants. Infants less than 25 weeks corrected gestational age are frequently the most difficult group for which to provide adequate nutrition due to minimal energy stores and high fluid losses. Nutrient delivery becomes an integral, but also very challenging part in their management. Early administration of intravenous nutrients provides a critical bridge to full enteral nutrition. However, enteral feeding is challenging due to immaturities of the intestinal tract, feeding intolerance and the risk of catastrophic gastrointestinal disease such as necrotizing enterocolitis (NEC). Decreased gastric acid production, increased gut permeability, reduced immunoglobulins, immature intestinal epithelia and a decreased mucin barrier all contribute to weakness to gastrointestinal insult. This review aims to illustrate the importance of enteral feeding and the common challenges and approaches in the nutrition of infants born at this age. |
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| Keywords: | Necrotizing Enterocolitis Spontaneous Intestinal Perforation Oropharyngeal Colostrum Human Milk Milk Fortification Neonatal Nutrition Gastric Residuals Intestinal Microbiome Intestinal Metabolome NEC" },{" #name" :" keyword" ," $" :{" id" :" pc_Xe6moeGOko" }," $$" :[{" #name" :" text" ," _" :" Necrotizing Enterocolitis SIP" },{" #name" :" keyword" ," $" :{" id" :" pc_guIfYN0SI4" }," $$" :[{" #name" :" text" ," _" :" Spontaneous Intestinal Perforation HMF" },{" #name" :" keyword" ," $" :{" id" :" pc_Q1XWfJliz9" }," $$" :[{" #name" :" text" ," _" :" Human Milk Fortifier OPC" },{" #name" :" keyword" ," $" :{" id" :" pc_Ja2C2brL7H" }," $$" :[{" #name" :" text" ," _" :" Oropharyngeal Colostrum |
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