Current principles of nutritional management of late preterm infants

Abstract

Neonates born between 34 0/7 and 36 6/7 weeks of gestation are considered late preterm (LPT) and constitute the largest group of all preterm infants. The rate of morbidity and mortality, as well as the frequency of repeated hospitalizations among LPT infants are significantly higher compared to full-term infants, which is explained by immaturity due to the lack of a critical period of their intrauterine growth and development. Fairly common they face nutritional problems leading to adverse immediate and long-term outcomes. Until recently, the lack of clear feeding recommendations for LPT infants determined the use of individual approaches to optimize their nutrition. The annual increase in the number of LPT infants has prompted the accumulation of new scientific information concerning both the anatomical and physiological characteristics and principles of development of these children in general and specific problems, including those related to nutrition. Comprehensive support and appropriate breastfeeding are the cornerstone of adequate nutrition for LPT infants. Depending on factors such as gestational age, birth weight, and comorbidities, it is often necessary to increase nutritional support, including the use of breast milk fortifiers, nutrientenriched formulas, and parenteral nutrition prescription. The process of achieving normal nutritional status in LPT infants can be complicated by episodes of hypoglycemia and prolonged jaundice, delay in postnatal growth and development, which requires a special approach. This review highlights the most common problems of nutritional management of LPT infants and provides current recommendations for optimal feeding of this group of preterm infants. Key words: late preterm infant, nutritional requirements, breastfeeding, donor milk, specialized formula, breast milk fortifiers, hypoglycemia, hyperbilirubinemia