PEDIATRICS Vol. 107 No. 4 April 2001, pp. 683-689
Growth of Preterm Infants Fed Nutrient-Enriched or Term Formula After Hospital Discharge
Received Mar 24, 2000; accepted Sept 7, 2000.
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From the * University of South Florida College of Medicine,
Department of Pediatrics, Division of Neonatology, Tampa, Florida;
Los Angeles County and University of Southern California School of
Medicine, Division of Neonatal-Perinatal Medicine, Los Angeles,
California; § Children's Mercy Hospital, Kansas City, Missouri;
University of Iowa Hospitals and Clinics, Iowa City, Iowa; ¶ All
Children's Hospital, St Petersburg, Florida; and # Ross Products
Division, Abbott Laboratories, Columbus, Ohio.
Objective. At hospital discharge, preterm infants may have low body stores of nutrients, deficient bone mineralization, and an accumulated energy deficit. This double-blind, randomized study evaluated the growth of premature infants with birth weights <1800 g who were fed a 22 kcal/fl oz nutrient-enriched postdischarge formula (PDF) or a 20 kcal/fl oz term-infant formula (TF) from hospital discharge to 12 months' corrected age (CA).
Methods. Infants were randomized to PDF or TF a few days
before hospital discharge with stratification by gender and birth
weight (<1250 g or 
1250 g). The formulas were fed to 12 months' CA.
Growth was evaluated using analysis of variance controlling for site, feeding, gender, and birth weight group. Interaction effects were also
assessed. Secondary analyses included a repeated measures analysis and
growth modeling.
Results. One hundred twenty-five infants were randomized;
74 completed to 6 months' CA and 53 to 12 months' CA. PDF-fed infants
weighed more than TF-fed infants at 1 and 2 months' CA, gained more
weight from study day 1 to 1 and 2 months' CA, and were longer at 3 months' CA. There were significant interactions between feeding and
birth weight group
among infants with birth weights <1250 g, those
fed PDF weighed more at 6 months' CA, were longer at 6 months' CA, had larger head circumferences at term 1, 3, 6, and 12 months' CA, and
gained more in head circumference from study day 1 to term and to 1 month CA. The repeated measures and growth modeling analyses confirmed
the analysis of variance results. The PDF formula seemed to be of
particular benefit for the growth of male infants. Infants fed the PDF
consumed less formula and had higher protein intakes at several time
points. Energy intakes, however, were not different.
Conclusions. Growth was improved in preterm infants fed a nutrient-enriched postdischarge formula after hospital discharge to 12 months' CA. Beneficial effects were most evident among infants with birth weights <1250 g, particularly for head circumference measurements. Key words: nutrition, preterm, low birth weight, growth.
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