Some Premature Infants Benefit From Enriched Formula

Jenni Laidman

October 29, 2012

Preterm infants of adequate weight benefitted from consuming a nutrient-enriched formula, but preemies small for their gestational age did not, according to results from a study published online October 29 and in the November issue of Pediatrics.

Paola Roggero, MD, PhD, from the neonatal intensive care unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Italy, and colleagues randomly assigned 207 newborns at 32 weeks of age or younger and/or with a birth weight of 1500 g or less to receive either regular formula or enriched formula until 6 months term-corrected age. Eighty-four of the infants were categorized as small for gestational age, and 123 were judged adequate for gestational age (AGA). Infant growth was assessed at 1, 3, 6, and 12 months' corrected age.

Although growth was similar for both infant groups, regardless of the formula, the AGA babies receiving the enriched formula had a lower percentage of fat mass than AGA babies receiving regular formula.

In addition, AGA infants receiving the enriched formula had greater mean head circumference growth at 6 and 12 months than AGA babies fed regular formula.

"This finding is of importance because the preterm infants are at risk for poor development outcome. Indeed, it is known that there is a strict relationship between the growth pattern of head circumference and the developmental outcome in the medium term," the authors write.

In contrast, babies who were small for gestational age showed no significant differences in head size or fat mass, regardless of which formula they consumed.

Preterm infants need to catch up with their peers in size to ensure optimal neurodevelopment, the authors note, but data show that when infants gain weight quickly, it is associated with the development of metabolic syndrome later in life. Preterm babies often show increased or aberrant fat gain, the authors write, suggesting that protein intake may be too limited.

The enriched formula contained 7 kcal more energy, as well as increased protein, protein-to-energy ratio, fat, carbohydrates, docosahexaenoic acid, arachidonic acid, vitamin D, calcium, and phosphorus.

The authors have disclosed no relevant financial relationships.

Pediatrics. 2012;130:e1215-e1221.