Enhanced Feeding and Diminished Postnatal Growth Failure in Very‐Low‐Birth‐Weight Infants

Objective: The aim of the present study was to determine whether an increased supply of energy, protein, essential fatty acids, and vitamin A reduces postnatal growth failure in very‐low‐birth‐weight infants. Methods: Fifty infants with birth weight <1500 g were randomized to an intervention (n = 24) or a control (n = 26) feeding protocol within 24 hours after birth. Forty‐four infants were included in the final analysis. This study was discontinued because of an increased occurrence of septicemia in the intervention group. Results: The intervention group had a lower mean birth weight ( P = 0.03) and a higher proportion of infants small‐for‐gestational age ( P = 0.04) than the control group. Other baseline characteristics were similar. The median (interquartile range) energy and protein supplies during the first 4 weeks of life were higher in the intervention group: 139 (128–145) versus 126 (121–128) kcal · kg −1 · day −1 ( P < 0.001) and 4.0 (3.9–4.2) versus 3.2 (3.1–3.3) g · kg −1 · day −1 ( P < 0.001). The infants in the intervention group regained birth weight faster ( P = 0.001) and maintained their z scores for weight and head circumference from birth to 36 weeks' postmenstrual age (both P < 0.001). The median (interquartile range) growth velocity was 17.4 (16.3–18.6) g · kg −1 · day −1 in the intervention group and 13.8 (13.2–15.5) g · kg −1 · day −1 in the control group ( P < 0.001). In line with the improved growth in the intervention group, the proportion of growth‐restricted infants was 11 of 23 both at birth and at 36 weeks' postmenstrual age, whereas this proportion increased among the controls from 4 of 21 to 13 of 21 ( P = 0.04). Conclusions: Enhanced supply of energy, protein, essential fatty acids, and vitamin A caused postnatal growth along the birth percentiles for both weight and head circumference.