The Feeding of Premature Infants

Summary The operating of a Premature Center, installed in a children's hospital, which forms part of a Medical Unit together with a large Maternity Unit, is described. The feeding routine used in 311 prematures admitted in a 7‐month period is studied. Schenistically this routine is the following: initial complete fasting period during the first 24 hours of life, followed by small fractionated feeds, 8 or 10 a day, of either skimmed or half skimmed breast milk, with added amounts of amino acids after the 9th day. The feeds are gradually increased in volume and decreased in frequency, so that by the third week the prematures only receive 5 meals in the 24‐hour period. The calorie intake during the first week is under 70 calories per kg and afterwards never exceeds 100 or 115. To replace human milk, babeurre at greater dilutions than usual is used, a preparation that supplies 53 calories for every 100 cc, and is composed of 3 g of protein, 0.8 g of fat and 9.5 g of carbohydrates per cent. After the third week, 300 cc of this formula, with added aminoacids is given. Thus the premature receives 4 to 6 g of protein, 1.5 to 3 g of fat, and 16 to 30 g of carbohydrates per kg per day. The results obtained are analyzed, revealing a 39.3 per cent death rate, which, although high, is lower than those registered for a similar group in the different maternity hospitals of this country. This high figure is explained, besides the fact that admission is restricted to prematures under 2000 g at birth (accepting only complicated prematures over this weight), by the unfavourable general condition of these prematures on arrival. Of the survivors, 65 per cent adjust themselves to Holt's schematic curves.