Nutrition
Infants born prematurely miss an important window of intrauterine
growth. Care providers are limited in their ability
to deliver calories and nutrients, yet these infants
have very high energy requirements to meet basic metabolic
functions, even without their need to grow. Delay
in establishing positive nitrogen balance with early
introduction of protein and lipids is known to decrease
alveolar number and delay extrauterine growth. Establishment
of enteral feeds as early as possible with maternal
breast milk provides the infant with growth factors found
in maternal milk such as inositol, which has a role in cell
membrane maintenance and maturation of pulmonary surfactant.
Infants with BPD/CLD may need up to 130 kCal/
kg/day to achieve positive growth. Some of these infants
are fluid sensitive, and meeting high caloric needs with a
restricted fluid intake can be a clinical challenge.