Weight gain composition in preterm infants with dual energy X-ray absorptiometry

Whole body composition was investigated using dual energy x-ray absorptiometry in 54 healthy preterm infants, birth weight < 1750 g, who were fed fortified human milk (n = 20) and preterm formula (n = 34) when full enteral feeding was attained and then again 3 wk later at around the time of discharge. Weight gain composition was calculated from the difference between the earlier and later measurement. The minimal detectable changes in whole body composition over time according to the variance of the population (within groups of 20 infants) and the minimal detectable changes according to the dietary intervention (between two groups of 20 infants) were determined at 5% significance and 80% power. Whole body composition was similar in the two groups at the initial measurement, but all the measured variables differed at the time of the second measurement. Formula-fed infants showed a greater weight gain (19.9 +/- 3.2 versus 15.9 +/- 2.2 g.kg(-1).d(-1), p < 0.05), fat mass deposition (5.1 +/- 1.9 versus 3.3 +/- 1.3 g.kg(-1).d(-1), p < 0.05), bone mineral content gain (289 +/- 99 versus 214 +/- 64 mg.kg(-1).d(-1), p < 0.05), and increase in bone area (1.6 +/- 0.4 versus 1.3 +/- 0.3 cm(2).kg(-1).d(-1), p < 0.05) compared with the fortified human milk group. From these data, a minimal increase from the first measurement of 111 g lean body mass, 68 g fat mass, and 3. 1 g bone mineral content is needed to be detectable in a longitudinal study that includes 20 infants. For significance between two groups of 20 infants around the time of discharge, dietary intervention needs to achieve minimal differences of 160 g lean body mass, 86 g fat mass, and 4.1 g bone mineral content. With respect to weight gain composition, the minimal differences required to reach significance are 2.1 g.kg(-1).d(-1) for gain in lean body mass, 1.2 g.kg(-1).d(-1) for gain in fat mass, and 76 mg.kg(-1). d(-1) for gain in bone mineral content. We conclude that dual energy x-ray absorptiometry allows evaluation of the effects of dietary intervention on whole body and weight gain composition in preterm infants during the first weeks of life.     

Birth weight categorization according to gestational age does not reflect percentage body fat in term and preterm newborns

This study was performed to prove the applicability of the small-for-gestational age (SGA), appropriate-for-gestational age (AGA), and large-for-gestational age (LGA) classification depending on birth weight to predict percentage body fat (%BF) measured by dual-energy X-ray absorptiometry (DXA) in term and preterm infants. The data of 159 healthy term and preterm neonates (87 boys and 72 girls) with a gestational age at delivery of 38.4 weeks from two longitudinal studies were analyzed. Anthropometry and body composition data were assessed within the first 10 days after birth. Correlations between anthropometric parameters and fat mass measured by DXA were calculated. Prevalences of observations with low, middle, and high %BF measured by DXA were compared between SGA, AGA, and LGA groups, according to sex and gestational age. In term infants, 42.9% of the newborns with less than 10% body fat were classified to be AGA; 9.9% of all AGA newborns had less than 10% body fat. For the whole group, among the ratios investigated, the weight-length ratio (r=0.82) showed the best correlation to fat mass measured by DXA. The %BF at the time of study was higher in girls (14.75%) than in boys (11.95%). In conclusion, traditional classification based on birth weight centiles does not reflect %BF in term and preterm newborns.     

Growth hormone improves mobility and body composition in infants and toddlers with Prader-Willi syndrome

OBJECTIVES: To determine the effect of growth hormone (GH) on body composition and motor development in infants and toddlers with Prader-Willi syndrome (PWS). STUDY DESIGN: Twenty-nine subjects with PWS (4-37 months of age) were randomized to GH treatment (1mg/m 2 /day) or observation for 12 months. Percent body fat, lean body mass, and bone mineral density were measured by dual x-ray absorptiometry; energy expenditure was measured by deuterium dilution; and motor constructs of mobility (M) and stability (S) were assessed using the Toddler Infant Motor Evaluation (TIME). RESULTS: GH-treated subjects, compared with controls, demonstrated decreased percent body fat (mean, 22.6% +/- 8.9% vs 28.5% +/- 7.9%; P < .001), increased lean body mass (mean, 9.82 +/- 1.9 kg vs 6.3 +/- 1.9 kg; P < .001), and increased height velocity Z scores (mean, 5. 0 +/- 1.8 vs 1.4 +/- 1.0; P < .001). Patients who began GH before 18 months of age showed higher mobility skill acquisition compared with controls within the same age range (mean increase in raw score, 284 +/- 105 vs 206 +/- 63; P < .05). CONCLUSIONS: GH treatment of infants and toddlers with PWS for 12 months significantly improves body composition and when begun before 18 months of age increases mobility skill acquisition. These results suggest that GH therapy instituted early in life may lessen deterioration of body composition in PWS while also accelerating motor development.     

Body composition of preterm infants during infancy

AIMS: To examine body composition in preterm infants. METHODS: Body composition was measured by dual energy x-ray absorptiometry (DEXA) at hospital discharge, term, 12 weeks, and at 6 and 12 months corrected age in 125 infants (birthweight < or = 1750 g, gestational age < or = 34 weeks). RESULTS: Body weight derived by DEXA accurately predicted that determined by conventional scales. In both sexes lean mass (LM), fat mass (FM), %FM, bone area (BA), bone mineral mass (BMM), and bone mineral density (BMD) increased rapidly during the study; significant changes were detectable between discharge and term. At 12 months, LM, BA, and BMM, but not FM, %FM, or BMD were greater in boys than in girls. Corrected for age, LM was less than those of the reference term infant; FM and %FM were similar; BMM was greater. Corrected for weight, LM was similar to those of the reference infant, while the FM and %FM of study infants were slightly greater. CONCLUSIONS: DEXA accurately measures body mass. Body composition in preterm boys and girls differs. Interpretation of DEXA values may depend on whether age or body weight are regarded as the appropriate reference.     

Postnatal growth failure in preterm infants: recovery of growth and body composition after term

BACKGROUND: Many preterm infants are significantly growth restricted at hospital discharge and are at increased risk for long-term growth failure. AIMS: To compare growth and weight gain composition after term between preterm infants who were growth retarded and those who were not. STUDY DESIGN: An observational longitudinal study was conducted. SUBJECTS: 35 preterm infants who showed growth retardation at term (group 1) and 26 preterm infants who did not (group 2). OUTCOME MEASURES: Growth and body composition were assessed at term and at 1, 2, 3, 4 and 5 months of corrected age. RESULTS: At term, and at 1, 2, and 3 months of corrected age, growth-retarded infants showed significantly lower body weight and fat mass than infants who did not develop growth retardation. The mean energy and protein intakes did not differ significantly between the two groups. Daily increases in body weight and fat mass between term and three months did not differ between the groups. However, during the fourth and fifth months, daily gains of body weight and fat mass were significantly greater in growth-retarded than in non-growth-retarded infants, and as a result, body weight and fat mass were comparable between the two groups at 4 and 5 months of corrected age. CONCLUSIONS: In terms of growth parameters and body composition, growth-retarded preterm infants recovered from postnatal growth failure within the fourth month of corrected age.     

Disproportionate alterations in body composition of large for gestational age neonates

OBJECTIVE: The objective was to compare dual-energy x-ray absorptiometry-measured body composition between large (LGA) and appropriate (AGA) birth weight for gestational age neonates.Study design: LGA term infants (n = 47) with birth weights > or =4000 g were compared with 47 gestational age-matched AGA infants; 11 LGA infants were born to mothers with gestational (9) or pregestational diabetes (2). Dual-energy x-ray absorptiometry scans were performed at 1.8 +/- 1.0 days after birth. RESULTS: Body weight and length were the dominant predictors of body composition in LGA and AGA neonates. However, LGA neonates had significantly (P <.001, all comparisons) higher absolute amounts of total body fat, lean body mass, and bone mineral content and had significantly (P <.001, all comparisons) higher proportions of total body fat and bone mineral content but lower lean body mass as a percent of body weight. The changes for total body fat and lean body mass as a percent of body weight were greatest (P <.001) in LGA infants whose mothers had impaired glucose tolerance. CONCLUSION: LGA neonates have higher body fat and lower lean body mass than AGA infants. Impaired maternal glucose tolerance exaggerated these body composition changes.     

The use of low-EPA fish oil for long-chain polyunsaturated fatty acid supplementation of preterm infants

Because docosahexaenoic acid (DHA) may be an essential nutrient for the visual and early cognitive development of preterm infants, DHA enrichment of preterm formulas has been recommended. This randomized trial was designed to study the n-6 and n-3 fatty acid status of healthy preterm infants fed a formula enriched with a low eicosapentaenoic-fish oil until 4 mo corrected age compared with that of infants fed a standard formula. A reference group of breast-fed infants was studied concurrently. The fatty acid content of red blood cell (RBC) phospholipid was assessed at enrollment, hospital discharge, expected term, and 3 and 6 mo postterm. The DHA content of RBC phospholipid was higher in infants fed the enriched versus the standard formula at hospital discharge, expected term, and 3 and 6 mo postterm. However, compared with infants fed the standard formula, infants fed the enriched formula had also higher RBC phospholipid eicosapentaenoic content (0.69 +/- 0.15% versus 0.25 +/- 0.12%, p < 0.001), and lower RBC phospholipid arachidonic acid content (15.1 +/- 0.93% versus 18.8 +/- 0.89%; p < 0.001). We conclude that supplementing preterm infants with low-eicosapentaenoic fish oil is effective in improving DHA status, but results in worsening of n-6 fatty acid status. We speculate that preterm infants may require a dietary supply of arachidonic acid as well as DHA if the same fatty acid status as that of breast-fed infants is to be achieved.     

Influence of protein and energy intakes on body composition of formula-fed preterm infants after term

The aim of the present study was to evaluate changes in body composition in 48 preterm infants in relation to protein and energy intakes from term up to 3 months of corrected age, using air displacement plethysmography. Protein intake (grams per kilogram per day) was negatively associated with percentage of fat mass at 1 month of corrected age. The high-protein-intake group showed greater gain in lean body mass gain than did the low-protein-intake group. This finding suggests that during the first month of corrected age, high protein intake results in a significantly different weight gain composition.     

The effects of early postnatal dexamethasone therapy on pulmonary outcome in premature infants with respiratory distress syndrome: a two-year follow-up study

AIM: To evaluate the pulmonary outcome at corrected age of 2 y on preterm infants who participated in a double-blind trial of early postnatal dexamethasone therapy (< 12 h after birth) for the prevention of chronic lung disease. METHODS: Clinical respiratory status, blood gases, acid-base balance and pulmonary function were evaluated at corrected age of 2 y in 116 preterm infants (59 infants in the control group; 57 in the dexamethasone-treated group). In the dexamethasone-treated group, dexamethasone was administered intravenously every 12 h in tapering doses: 0.25 mg/kg on days 1 through 7, 0.12 mg/kg on days 8 through 14, 0.05 mg/kg on days 15 through 21, and 0.02 mg/kg on days 21 through 28. RESULTS: The clinical and laboratory characteristics in the perinatal period were comparable between the groups. At the time of follow-up (mean +/- SD corrected age was 25.1 +/- 4.8 mo for the control group and 24.6 +/- 5.1 mo for the dexamethasone-treated group), there was a slightly lower mean body weight and body length, and a lower psychomotor developmental index in the dexamethasone-treated group than in the control group (10.9 +/- 2.1 vs 11.5 +/- 1.9 kg, 84.4 +/- 6.1 vs 85.9 +/- 5.8 cm, and 82 +/- 24 vs 89 +/- 26, respectively); however, these differences were not statistically significant. There were no significant differences between the control and dexamethasone-treated groups in clinical respiratory status, blood gases, acid-base balance or in lung mechanics (V(T): 9.5 +/- 2.0 vs 9.4 +/- 1.9 ml/kg; V(min): 0.23 +/- 0.04 vs 0.23 +/- 0.03 l/min/kg; C(RS): 13.1 +/- 3.9 vs 12.6 +/- 3.6 ml/kPa/kg; R(RS): 1.56 +/- 0.64 vs 1.62 +/- 0.58 kPa/l/s, respectively). CONCLUSION: There was no apparent adverse respiratory outcome associated with early postnatal dexamethasone therapy.     

Bone densitometry by dual-energy X-ray absorptiometry (DXA) in preterm newborns compared with full-term peers in the first six months of life

ObjectivesTo longitudinally assess bone mineral content (BMC), bone mineral density (BMD), and whole-body lean mass obtained through bone densitometry by dual-energy X-ray absorptiometry (DXA) in preterm newborns (PTNs) and compare them with full-term newborns (FTNs) from birth to 6 months of corrected postnatal age.MethodsA total of 28 adequate for gestational age (AGA) newborns were studied: 14 preterm and 14 full-term newborns. DXA was used to determine BMC, BMD, and lean mass in three moments: 40 weeks corrected post-conceptual age, as well as 3 and 6 months of corrected postnatal age. PTNs had gestational age ≤ 32 weeks at birth and were fed their mother's own milk or milk from the human milk bank.ResultsAll infants had an increase in BMC, BMD, and lean body mass values during the study. PTNs had lower BMC, BMD, and lean mass at 40 weeks of corrected post-conceptual age in relation to FTNs (p < 0.001, p < 0.001, p = 0.047, respectively). However, there was an acceleration in the mineralization process of PTNs, which was sufficient to achieve the normal values of FTNs at 6 months of corrected age.ConclusionsThis study suggests that bone densitometry by dual-energy X-ray absorptiometry is a good method for the assessment of body composition parameters at baseline, and at the follow-up of these PTNs.     

Growth hormone improves body composition and motor development in infants with Prader-Willi syndrome after six months

BACKGROUND: Infants with Prader-Willi syndrome (PWS) show abnormalities of body composition. Children with PWS treated with growth hormone (GH) demonstrate improved body composition and motor skills. OBJECTIVE: To assess body composition and motor changes in infants with PWS following 6 months GH therapy. METHODS: Twenty-five infants with PWS (mean age 15.5 mo) underwent dual energy X-ray absorptiometry (DEXA) assessment of body composition, and motor assessment with the Toddler Infant Motor Evaluation (TIME). Patients were then randomized to treatment (Genotropin, 1 mg/m2/day) or control, with reassessment at 6 months. RESULTS: GH treatment significantly increased lean body mass (6.4 +/- 2.4 kg to 8.9 +/- 2.7 kg) and decreased body fat (27.6 +/- 9.9% to 22.4 +/- 10.3%). Age equivalent motor scores improved 4 months in the treated group vs 2 months in controls (p < 0.01). CONCLUSIONS: Infants with PWS show significant body composition and motor development improvement following 6 months GH therapy. We are investigating whether this improvement leads to long-term reductions in obesity.     

Neonatal body composition: dual-energy X-ray absorptiometry, magnetic resonance imaging, and three-dimensional chemical shift imaging versus chemical analysis in piglets.

An animal study to evaluate dual-energy x-ray absorptiometry (DXA) and magnetic resonance (MR) imaging and spectroscopy for measurement of neonatal body composition was performed. Twenty-three piglets with body weights ranging from 848 to 7550 g were used. After measuring total body water, animals were killed and body composition was assessed using DXA and MR (1.5 T; MR imaging, T1-weighted sagittal spin-echo sequence; MR spectroscopy, three-dimensional chemical shift imaging) as well as chemical carcass analysis (standard methods) after homogenization. Body composition by chemical analysis (percent of body weight, mean +/- SD) was as follows: body water, 75.3 +/- 3.9%; total protein, 13.9 +/- 8.8%; and total fat, 6.5 +/- 3.7%. Absolute content of fat and total ash was 7-674 and 35-237 g, respectively. Mean hydration of fat-free mass was 0.804 +/- 0.011 g/kg and decreased with increasing body weight (r2 = 0.419) independent of age. Using DXA, bone mineral content was highly correlated with calcium content (r2 = 0.992), and calcium per bone mineral content was 44.1 +/- 4.2%. DXA fat mass correlated with total fat (r2 = 0.961). Using MR, spectroscopy and chemical analysis were highly correlated with fat-to-water ratio (r2 = 0.984) and absolute fat content (r2 = 0.988). Total fat by MR imaging volumetry showed a lower correlation (r2 = 0.913) and overestimated total fat by a factor of 2.46. Conversion equations for DXA were developed (total fat = 1.31 x fat mass measured by DXA--68.8; calcium = 0.402 x bone mineral content + 1.7), which improved precision and accuracy of DXA measurements. In conclusion, both DXA and MR spectroscopy give accurate and precise estimates of neonatal body composition and may become valuable tools for the noninvasive assessment of neonatal growth and nutritional status.     

The relation between skeletal maturation and adiposity in African American and Caucasian children.

OBJECTIVE: African American children have earlier pubertal and skeletal maturation and a higher body mass index (BMI) than Caucasian children. We tested the hypothesis that advanced bone age in African American children is accounted for by their greater adiposity. STUDY DESIGN: We studied 252 African American (n = 97) and Caucasian (n = 155) children aged 5 to 12 years. Skeletal age was determined by a radiologist blinded to clinical details. The difference between bone age (BA) and chronological age (CA) (noted as BA - CA) and the ratio of bone age to chronological age (BA/CA) were determined. Analysis of covariance was used to adjust skeletal maturation for the effects of adiposity, as measured by BMI, BMI standard deviation score (BMI SDS), and fat mass by dual energy x-ray absorptiometry (DXA). RESULTS: African American children were significantly heavier than Caucasians (BMI SDS 2.7 +/- 3.4 vs 1.7 +/- 2.4, P <.05). Both BA - CA (0.75 +/- 1.46 vs 0.28 +/- 1.38, P <.05) and BA/CA (1.09 +/- 0.17 vs 1.03 +/- 0.16, P <.05) were significantly greater in African Americans than Caucasians. BA - CA and BA/CA were significantly correlated with lean body mass, BMI, BMI SDS, and DXA fat mass (all r > 0.46, P <.001). Neither BA - CA nor BA/CA of African Americans and Caucasians were significantly different after correction for lean body mass and measures of adiposity, including BMI, BMI SDS, or DXA fat mass. CONCLUSION: Skeletal age is more advanced in African American than Caucasian children and is significantly related to body mass. In large measure, the advancement in skeletal maturation of prepubertal and early pubertal African American children can be accounted for by their greater adiposity.     

Early life factors predict abnormal growth and bone accretion at prepuberty in former premature infants with/without neonatal dexamethasone exposure

Growth, bone, and body composition were studied at prepuberty in former very low birth weight (VLBW) infants who received dexamethasone (DEX) for bronchopulmonary dysplasia (BPD) compared with VLBW infants without DEX and term-born infants (TERM) to identify early life risk factors for later low bone mass. Children (56 girls/63 boys, 5-10 y) previously studied in neonatal life were recruited into three groups: VLBW + DEX, VLBW - DEX, and TERM children. Anthropometry and whole body bone, fat, and lean mass were measured. At prepuberty, the average height and weight for VLBW + DEX group were significantly lower than that for VLBW - DEX and TERM. Both VLBW groups had lower bone mass even adjusted for height and lean mass than TERM children and lower lean mass both total and adjusted for height. Z-scores for whole body bone mineral content below -1.5 occurred in 27.9% of VLBW + DEX children. The key factors for low bone mass were earlier gestational age and having BPD with DEX in neonatal life. In former VLBW infants, growth and bone mass attainment before puberty can be predicted from early life variables. VLBW + DEX children may be protected from overweight, but are at risk for short stature and low bone mass.     

Bone metabolism and circulating IGF-I and IGFBPs in dexamethasone-treated preterm infants

AIM: To characterize the ontogeny of circulating IGF-I, the IGF binding proteins (IGFBPs) and biochemical markers of bone turnover in dexamethasone (DEX)-treated preterm infants with chronic lung disease. METHODS: Plasma and urine samples from 17 infants were obtained prior to DEX, after 9-12 days of DEX and 10 days after the completion of DEX to assess plasma IGF-I, IGFBPs, osteocalcin and urinary N-telopeptide. Nutrient intakes and growth were monitored from birth until term corrected age at which time body composition was evaluated by dual energy X-ray absorptiometry. RESULTS: Although nutrient intakes did not differ during or after DEX, weight gain (115 vs. 174 g/week) and length gain (0.7 vs. 1.0 cm/week) were higher after DEX treatment. Plasma IGF-I, IGFBP-3 and osteocalcin increased over time. N-telopeptide was the only biochemical parameter which appeared to be suppressed during DEX (1342 nM bone collagen equivalents/mM creatinine vs. 2486 (pre-DEX) and 2292 (post-DEX)). At term corrected age, bone mineral content was lower in dexamethasone-treated infants compared to preterm and term reference infants. CONCLUSION: Changes in circulating IGFBP-2 and IGFBP-3 paralleled the changes reported in non-steroid-treated infants; however, it remains uncertain whether the natural rise in IGF-I was suppressed by DEX treatment. Assessment of these circulating components provided limited insight into the mechanisms by which DEX alters growth and bone turnover.     

Body composition,as assessed by bioelectrical impedance spectroscopy and dual-energy X-ray absorptiometry,in a healthy paediatric population

The aim of this study was to determine the level of agreement between body composition measurements by dual-energy X-ray absorptiometry (DXA), single-frequency bioelectrical impedance analysis (BIA) and multifrequency bioelectrical impedance spectroscopy (BIS). Fat-free mass (FFM), body fat mass and body fatness (percentage fat) were measured by DXA, BIA and BIS in 61 healthy children (37M, 24F, aged 10.9-13.9 y). Estimates of FFM, body fat mass and body fatness were highly correlated (r = 0.73-0.96, p < 0.0001) between the different methods. However, a Bland-Altman comparison showed wide limits of agreement between the methods. The mean differences between methods for FFM ranged from -2.31 +/- 7.76 kg to 0.48 +/- 7.58 kg. Mean differences for body fat mass ranged from 0.16 +/- 5.06 kg to 2.95 +/- 5.65 kg and for body fatness from -2.3 +/- 7.8% to 0.8 +/- 9.3%. Calculations of body composition with BIS were not superior to BIA. However, BIA overestimated fat mass in lean, subjects and underestimated fat mass in overweight subjects more than BIS, compared with DXA. CONCLUSION: The methods used provided estimates of FFM, body fat mass and body fatness that were highly correlated in a population of healthy children. However, the large limits of agreement derived from the Bland-Altman procedure suggest that the methods should not be used interchangeably.     

Is term newborn body composition being achieved postnatally in preterm infants?

Background

The American Academy of Pediatrics (AAP) recommends that preterm infants' growth duplicates fetal growth rates and that body composition replicates in utero body composition.

Aims

To compare the total body fat mass between preterm infants assessed at term corrected age and full-term newborns, and to investigate the effects of gestational age, gender, weight increase, being breast fed on total adiposity.

Study design

Prospective observational study.

Subjects

One hundred and ten preterm infants [mean (SD) gestational age: 29.9 (2.3) weeks; birth weight: 1118 (274) g], and 87 full term [mean (SD) 38.6 (1.21) weeks, 3203 (385) g], breastfed infants.

Outcome measures

Growth and body composition by means of a pediatric air displacement system were assessed at term corrected age in preterm infants and on day 3 of life in full term infants.

Results

Weight, length and head circumference were smaller in the preterm group as compared to the term group. Mean (SD) percentage of fat mass in preterm infants was significantly higher as compared to term infants [14.8 (4.4) vs 8.59 (3.71), P < 0.0001]. Fat mass was negatively correlated with gestational age (P < 0.001), and positively associated with weight increase (P < 0.05).

Conclusions

Our data suggest that body composition, in terms of fat mass, in preterm infants at term corrected age is different from that of full term newborns.     

Postnatal "speed of sound" decline in preterm infants: an exploratory study

"Speed of sound" (SOS), measured by quantitative ultrasound, is a noninvasive method of assessing bone status. At expected term and 1, 2, and 3 months of corrected age, bone status and body fat mass were assessed by quantitative ultrasound and by an air-displacement system in 53 preterm infants to explore whether longitudinal changes in bone health were influenced by body fat mass. SOS decreased within the first month of corrected age. Body fat mass increased significantly. No correlation between SOS and body fat mass was found. SOS was not influenced by changes in body fat mass. The decline in SOS may be ascribed to bone structure factors.     

Factors affecting body composition in preterm infants: Assessment techniques and nutritional interventions

Limited research has been conducted that elucidates the growth and body composition of preterm infants. It is known that these infants do not necessarily achieve extra-utero growth rates and body composition similar to those of their term counterparts. Preterm infants, who have difficulty in achieving these growth rates, could suffer from growth failure. These infants display an increased intra-abdominal adiposity and abnormal body composition when they achieve catch-up growth. These factors affect the quality of weight gain, as these infants are not only shorter and lighter than term infants, they also have more fat mass (FM) and less fat-free mass (FFM), resulting in a higher total fat percentage. This could cause metabolic syndrome and cardiovascular problems to develop later in a preterm infant's life. The methods used to determine body composition in preterm infants should be simple, quick, non-invasive and inexpensive. Available literature was reviewed and the Dauncey anthropometric model, which includes skinfold thickness at two primary sites and nine body dimensions, is considered in this review the best method to accurately determine body composition in preterm infants, especially in resource-poor countries. It is imperative to accurately assess the quality of growth and body composition of this fragile population in order to determine whether currently prescribed nutritional interventions are beneficial to the overall nutritional status and quality of life—in the short- and long-term—of the preterm infant, and to enable timely implementation of appropriate interventions, if required.