Pub Date : 2025-10-01DOI: 10.1016/j.siny.2025.101654
Maëlig Abgral , Francesca M. Russo , Jan Deprest , Alexandra Benachi
Congenital diaphragmatic hernia is most often diagnosed prenatally, and accurate assessment is crucial for prognosis parental counselling and therapeutic planning. The assessment of pulmonary hypoplasia is currently the most relevant prognostic indicator. Ultrasound and MRI parameters such as the observed-to-expected lung-to-head ratio and total fetal lung volume serve as the primary predictors of neonatal outcome. However, these markers are not predictive of associated complications like persistent pulmonary hypertension of neonates and cardiac dysfunction, which also significantly influence survival and morbidity. Although new imaging parameters have been proposed, their clinical utility is limited by insufficient validation and inter-center variability. This review critically evaluates current prenatal imaging methods for congenital diaphragmatic hernia, highlighting their strengths and limitations. A better understanding of the underlying pathophysiology, alongside efforts to develop standardized, reproducible and eventually predictive markers, is essential to refine prognosis, optimize fetal therapy selection, eventually improving outcomes for affected neonates.
{"title":"Prenatal assessment and prediction in CDH: for what purpose?","authors":"Maëlig Abgral , Francesca M. Russo , Jan Deprest , Alexandra Benachi","doi":"10.1016/j.siny.2025.101654","DOIUrl":"10.1016/j.siny.2025.101654","url":null,"abstract":"<div><div>Congenital diaphragmatic hernia is most often diagnosed prenatally, and accurate assessment is crucial for prognosis parental counselling and therapeutic planning. The assessment of pulmonary hypoplasia is currently the most relevant prognostic indicator. Ultrasound and MRI parameters such as the observed-to-expected lung-to-head ratio and total fetal lung volume serve as the primary predictors of neonatal outcome. However, these markers are not predictive of associated complications like persistent pulmonary hypertension of neonates and cardiac dysfunction, which also significantly influence survival and morbidity. Although new imaging parameters have been proposed, their clinical utility is limited by insufficient validation and inter-center variability. This review critically evaluates current prenatal imaging methods for congenital diaphragmatic hernia, highlighting their strengths and limitations. A better understanding of the underlying pathophysiology, alongside efforts to develop standardized, reproducible and eventually predictive markers, is essential to refine prognosis, optimize fetal therapy selection, eventually improving outcomes for affected neonates.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 3","pages":"Article 101654"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.siny.2025.101651
K. Saint Denny , J. Lawer , S. Mur , T.M. Prentice
Despite advances in care, Congenital Diaphragmatic Hernia remains a complex and challenging condition to manage and is often associated with long term morbidity. Families are required to navigate considerable uncertainty, challenges in prognostication and communication, and must adapt to an evolving clinical trajectory. This review addresses considerations and practical tips for healthcare professionals to improve the family and patient experience from diagnosis to adult care, from the perspective of clinicians and CDH families. This paper emphasizes the importance of including those with lived experience with CDH in defining topics of priority in research and in clinical and support interventions.
{"title":"Management of Congenital Diaphragmatic Hernia (CDH) care: Addressing what matters to patients and their families?","authors":"K. Saint Denny , J. Lawer , S. Mur , T.M. Prentice","doi":"10.1016/j.siny.2025.101651","DOIUrl":"10.1016/j.siny.2025.101651","url":null,"abstract":"<div><div>Despite advances in care, Congenital Diaphragmatic Hernia remains a complex and challenging condition to manage and is often associated with long term morbidity. Families are required to navigate considerable uncertainty, challenges in prognostication and communication, and must adapt to an evolving clinical trajectory. This review addresses considerations and practical tips for healthcare professionals to improve the family and patient experience from diagnosis to adult care, from the perspective of clinicians and CDH families. This paper emphasizes the importance of including those with lived experience with CDH in defining topics of priority in research and in clinical and support interventions.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 3","pages":"Article 101651"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.siny.2025.101652
Gabriel Guevara , K. Taylor Wild , Richard Keijzer , David J. McCulley
{"title":"Developmental pathophysiology and genetic contributions in CDH","authors":"Gabriel Guevara , K. Taylor Wild , Richard Keijzer , David J. McCulley","doi":"10.1016/j.siny.2025.101652","DOIUrl":"10.1016/j.siny.2025.101652","url":null,"abstract":"","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 3","pages":"Article 101652"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.siny.2025.101660
Anna Foth , David Tingay , Florian Kipfmueller
Congenital diaphragmatic hernia (CDH) remains one of the most challenging conditions to manage in neonatal intensive care, with outcomes determined by the complex interplay between pulmonary hypoplasia, pulmonary vascular remodeling, and ventricular dysfunction. Traditional treatment strategies, including high-frequency ventilation, inhaled nitric oxide, and vasopressor use, fail to account for the dynamic heterogeneity of CDH physiology and may contribute to persistently high mortality. Emerging evidence delineates three principal hemodynamic phenotypes: (1) preserved biventricular function with mild/no pulmonary hypertension (PH), (2) pre-capillary PH with or without right ventricular dysfunction, and (3) post-capillary PH with primary left ventricular (LV) dysfunction. Each phenotype demands distinct ventilatory and pharmacologic strategies, ranging from cautious respiratory support to targeted pulmonary vasodilators, inodilators, or LV-directed therapies. Ventilation in CDH is further complicated by profound lung inhomogeneity, the “baby lung” phenomenon, and susceptibility to ventilator-induced lung injury. Advances in lung-protective strategies, including low driving pressure, permissive hypercapnia, synchrony-enhancing modes, and real-time functional monitoring with echocardiography, lung ultrasound, electrical impedance tomography, and use of circulating biomarkers enable tailored interventions. A precision medicine approach, grounded in multimodal monitoring and gentle cardiopulmonary support, holds promise to optimize hemodynamic balance, reduce iatrogenic injury, and improve survival and long-term outcomes in infants with CDH.
{"title":"“Gentle” cardio-respiratory management in congenital diaphragmatic hernia: Time for a precision-medicine approach?","authors":"Anna Foth , David Tingay , Florian Kipfmueller","doi":"10.1016/j.siny.2025.101660","DOIUrl":"10.1016/j.siny.2025.101660","url":null,"abstract":"<div><div>Congenital diaphragmatic hernia (CDH) remains one of the most challenging conditions to manage in neonatal intensive care, with outcomes determined by the complex interplay between pulmonary hypoplasia, pulmonary vascular remodeling, and ventricular dysfunction. Traditional treatment strategies, including high-frequency ventilation, inhaled nitric oxide, and vasopressor use, fail to account for the dynamic heterogeneity of CDH physiology and may contribute to persistently high mortality. Emerging evidence delineates three principal hemodynamic phenotypes: (1) preserved biventricular function with mild/no pulmonary hypertension (PH), (2) pre-capillary PH with or without right ventricular dysfunction, and (3) post-capillary PH with primary left ventricular (LV) dysfunction. Each phenotype demands distinct ventilatory and pharmacologic strategies, ranging from cautious respiratory support to targeted pulmonary vasodilators, inodilators, or LV-directed therapies. Ventilation in CDH is further complicated by profound lung inhomogeneity, the “baby lung” phenomenon, and susceptibility to ventilator-induced lung injury. Advances in lung-protective strategies, including low driving pressure, permissive hypercapnia, synchrony-enhancing modes, and real-time functional monitoring with echocardiography, lung ultrasound, electrical impedance tomography, and use of circulating biomarkers enable tailored interventions. A precision medicine approach, grounded in multimodal monitoring and gentle cardiopulmonary support, holds promise to optimize hemodynamic balance, reduce iatrogenic injury, and improve survival and long-term outcomes in infants with CDH.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 3","pages":"Article 101660"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-13DOI: 10.1016/j.siny.2025.101632
David H. Adamkin
Human milk is the gold standard for the nutrition of very-low-birthweight (VLBW) infants. Pasteurized donor human milk (DM) should be provided for VLBW infants when own mother's milk (OMM) is not available. Prevention of Necrotizing enterocolitis (NEC) is an important short-term benefit associated with human milk feeding. Human milk alone does not meet the nutritional requirements for VLBW infants leading to nutritional inadequacy, postnatal growthfaltering,and risk of poor neurodevelopmental outcome. Human milk fortification with multicomponent fortifiers increases calories and provides additional protein and minerals and should minimize nutritional deficits. Human milk derived fortifiers (HMDF) provide an exclusive human milk diet but recent evidence to recommend their use over cow milk derived fortifiers is lacking. Individualized fortification using human milk analyzers in real time is an emerging practice that allows for a more personalized provision of nutrient needs.
{"title":"Use of human milk and fortification in the neonatal intensive care unit","authors":"David H. Adamkin","doi":"10.1016/j.siny.2025.101632","DOIUrl":"10.1016/j.siny.2025.101632","url":null,"abstract":"<div><div>Human milk is the gold standard for the nutrition of very-low-birthweight (VLBW) infants. Pasteurized donor human milk (DM) should be provided for VLBW infants when own mother's milk (OMM) is not available. Prevention of Necrotizing enterocolitis (NEC) is an important short-term benefit associated with human milk feeding. Human milk alone does not meet the nutritional requirements for VLBW infants leading to nutritional inadequacy, postnatal growthfaltering,and risk of poor neurodevelopmental outcome. Human milk fortification with multicomponent fortifiers increases calories and provides additional protein and minerals and should minimize nutritional deficits. Human milk derived fortifiers (HMDF) provide an exclusive human milk diet but recent evidence to recommend their use over cow milk derived fortifiers is lacking. Individualized fortification using human milk analyzers in real time is an emerging practice that allows for a more personalized provision of nutrient needs.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 2","pages":"Article 101632"},"PeriodicalIF":2.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-09DOI: 10.1016/j.siny.2025.101637
Sarah N. Taylor, Catherine O. Buck
The preterm infant misses fetal nutrition, and the nutritional deficit is proportional to the degree of preterm birth with very preterm infants demonstrating the greatest need for supplemental nutrition to overcome deficiencies. Preterm infants’ growth patterns are linked to both their risk for neurodevelopmental difficulties and to the development of obesity. Therefore, establishing healthy growth patterns by providing the best nutrition both in the hospital and post-hospital discharge is critical for long-term health. Despite numerous clinical trials, uncertainty persists as to the duration of nutritional supplement, the degree of benefit of maternal milk feedings, and the best short-term measures of growth and body composition to predict long-term outcomes. As more is learned about optimal post-discharge nutrition, it is very likely that best practice in post-discharge nutrition will include use of a standardized approach to deliver individualized care.
{"title":"Post-discharge nutrition to optimize preterm infant short- and long-term outcomes","authors":"Sarah N. Taylor, Catherine O. Buck","doi":"10.1016/j.siny.2025.101637","DOIUrl":"10.1016/j.siny.2025.101637","url":null,"abstract":"<div><div>The preterm infant misses fetal nutrition, and the nutritional deficit is proportional to the degree of preterm birth with very preterm infants demonstrating the greatest need for supplemental nutrition to overcome deficiencies. Preterm infants’ growth patterns are linked to both their risk for neurodevelopmental difficulties and to the development of obesity. Therefore, establishing healthy growth patterns by providing the best nutrition both in the hospital and post-hospital discharge is critical for long-term health. Despite numerous clinical trials, uncertainty persists as to the duration of nutritional supplement, the degree of benefit of maternal milk feedings, and the best short-term measures of growth and body composition to predict long-term outcomes. As more is learned about optimal post-discharge nutrition, it is very likely that best practice in post-discharge nutrition will include use of a standardized approach to deliver individualized care.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 2","pages":"Article 101637"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-09DOI: 10.1016/j.siny.2025.101639
Catalina Bazacliu, Juan Carlos Roig, Josef Neu
The GI tract-lung-brain axis refers to the communication network linking the gastrointestinal tract, central nervous system, and respiratory system. This axis is particularly significant in preterm neonates because their immune and nervous systems are undergoing rapid development and thus are susceptible to various conditions influenced by GI tract and lung microbiota that are key mediators in this axis. This communication network is connected via neural, hormonal, and immunological regulatory pathways, all of which are pivotal in disease pathogenesis and health. Here we provide a brief introduction to this axis along with interactive mechanisms and perturbations that can affect this system and the roles they play in health and disease.
{"title":"Gastrointestinal (GI)-lung-brain axis","authors":"Catalina Bazacliu, Juan Carlos Roig, Josef Neu","doi":"10.1016/j.siny.2025.101639","DOIUrl":"10.1016/j.siny.2025.101639","url":null,"abstract":"<div><div>The GI tract-lung-brain axis refers to the communication network linking the gastrointestinal tract, central nervous system, and respiratory system. This axis is particularly significant in preterm neonates because their immune and nervous systems are undergoing rapid development and thus are susceptible to various conditions influenced by GI tract and lung microbiota that are key mediators in this axis. This communication network is connected via neural, hormonal, and immunological regulatory pathways, all of which are pivotal in disease pathogenesis and health. Here we provide a brief introduction to this axis along with interactive mechanisms and perturbations that can affect this system and the roles they play in health and disease.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 2","pages":"Article 101639"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-09DOI: 10.1016/j.siny.2025.101634
Neena Modi
The term “human milk” conceals important differences between that from an infant's own mother and that obtained from a person or persons who have donated or sold their breast milk. These include differences in nutritional content, and a wide range of non-nutritional components that promote immune, metabolic, and brain development and have evolved over the course of time to transmit biological information from mother to infant. Human milk feeding to preterm babies also encompasses elements such as processing and storage, differences between feeding expressed breast milk versus suckling at the breast, and societal and economic considerations. Current evidence of clinical effectiveness of donated or commercial human milk, and whether macro and micronutrient supplementation are required indicates considerable uncertainty and the possibility of harm. Preterm nutrition is an emotive subject, but important evidence gaps need to be recognised, acknowledged, and addressed if the care of very preterm babies is to improve through a strong evidence-base.
{"title":"Human milk for preterm infants","authors":"Neena Modi","doi":"10.1016/j.siny.2025.101634","DOIUrl":"10.1016/j.siny.2025.101634","url":null,"abstract":"<div><div>The term “human milk” conceals important differences between that from an infant's own mother and that obtained from a person or persons who have donated or sold their breast milk. These include differences in nutritional content, and a wide range of non-nutritional components that promote immune, metabolic, and brain development and have evolved over the course of time to transmit biological information from mother to infant. Human milk feeding to preterm babies also encompasses elements such as processing and storage, differences between feeding expressed breast milk versus suckling at the breast, and societal and economic considerations. Current evidence of clinical effectiveness of donated or commercial human milk, and whether macro and micronutrient supplementation are required indicates considerable uncertainty and the possibility of harm. Preterm nutrition is an emotive subject, but important evidence gaps need to be recognised, acknowledged, and addressed if the care of very preterm babies is to improve through a strong evidence-base.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 2","pages":"Article 101634"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-09DOI: 10.1016/j.siny.2025.101638
Laiken Price , Kelly A. Orgel , Misty Good
Necrotizing enterocolitis (NEC) is an intestinal disease that predominantly occurs in preterm infants. While there are no definitive treatment options for NEC, the administration of human milk is protective against the development of NEC in preterm infants. However, human milk composition is highly dynamic, containing numerous bioactive components that can be affected by both maternal and perinatal factors. Furthermore, when maternal milk is unavailable, donor human milk, which goes through a rigorous preparation process including pooling and pasteurization, is used. The different pasteurization methods can have implications for the bioactive components of human milk. In this review, we explore the current literature surrounding the benefits of human milk in the prevention of NEC. We further review the bioactive components and the microbiome of human milk and the many factors that affect the diversity of milk content between human milk samples. Finally, we review the different methods of pasteurization and their effects on the components of human milk.
{"title":"Donor human milk pasteurization methods and the effect on milk components as they relate to Necrotizing enterocolitis","authors":"Laiken Price , Kelly A. Orgel , Misty Good","doi":"10.1016/j.siny.2025.101638","DOIUrl":"10.1016/j.siny.2025.101638","url":null,"abstract":"<div><div>Necrotizing enterocolitis (NEC) is an intestinal disease that predominantly occurs in preterm infants. While there are no definitive treatment options for NEC, the administration of human milk is protective against the development of NEC in preterm infants. However, human milk composition is highly dynamic, containing numerous bioactive components that can be affected by both maternal and perinatal factors. Furthermore, when maternal milk is unavailable, donor human milk, which goes through a rigorous preparation process including pooling and pasteurization, is used. The different pasteurization methods can have implications for the bioactive components of human milk. In this review, we explore the current literature surrounding the benefits of human milk in the prevention of NEC. We further review the bioactive components and the microbiome of human milk and the many factors that affect the diversity of milk content between human milk samples. Finally, we review the different methods of pasteurization and their effects on the components of human milk.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 2","pages":"Article 101638"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-09DOI: 10.1016/j.siny.2025.101636
Shipra Jain , Belal N. Alshaikh , Seham Elmrayed , Tanis R. Fenton
Preterm infants typically experience faster growth rates than term-born infants, often doubling their weight in six to eight weeks. However, many face challenges leading to growth faltering and suboptimal neurodevelopment. To achieve optimal growth, these infants often require fortified breastmilk or high-nutrient formula. While meeting nutrition and growth targets are essential, concerns arise about rapid postnatal growth during their catch-up phase, particularly regarding increased body fat at term-corrected age, possibly increasing their risk for obesity and chronic health conditions later. However, evidence suggests that although preterm infants may have higher body fat at term-corrected age, this difference diminishes by three months corrected age, aligning more closely with term-born infants. Systematic reviews of more than 20,000 individuals observed that small for gestational age preterm infants do not have higher adiposity in childhood and adulthood; rather, they exhibit lower body mass indexes, waist circumferences, similar body and visceral fat and blood pressure compared to their appropriate for gestational age preterm-born peers. Therefore, it is reassuring that promoting early growth in preterm infants does not necessitate a trade-off when it comes to supporting long-term metabolic outcomes versus neurodevelopment. Healthcare providers should encourage a responsive feeding approach, even in preterm infants, guided by infants' physiological needs, hunger and satiety once they exhibit feeding cues. This approach respects the child's developmental needs and encourages healthy eating habits, fostering positive parent-child feeding relationships, and ultimately allowing the child to grow and develop to their full potential without compromising their long-term health outcomes.
{"title":"Short- and longer-term growth and development of fat mass in preterm infants","authors":"Shipra Jain , Belal N. Alshaikh , Seham Elmrayed , Tanis R. Fenton","doi":"10.1016/j.siny.2025.101636","DOIUrl":"10.1016/j.siny.2025.101636","url":null,"abstract":"<div><div>Preterm infants typically experience faster growth rates than term-born infants, often doubling their weight in six to eight weeks. However, many face challenges leading to growth faltering and suboptimal neurodevelopment. To achieve optimal growth, these infants often require fortified breastmilk or high-nutrient formula. While meeting nutrition and growth targets are essential, concerns arise about rapid postnatal growth during their catch-up phase, particularly regarding increased body fat at term-corrected age, possibly increasing their risk for obesity and chronic health conditions later. However, evidence suggests that although preterm infants may have higher body fat at term-corrected age, this difference diminishes by three months corrected age, aligning more closely with term-born infants. Systematic reviews of more than 20,000 individuals observed that small for gestational age preterm infants do not have higher adiposity in childhood and adulthood; rather, they exhibit lower body mass indexes, waist circumferences, similar body and visceral fat and blood pressure compared to their appropriate for gestational age preterm-born peers. Therefore, it is reassuring that promoting early growth in preterm infants does not necessitate a trade-off when it comes to supporting long-term metabolic outcomes versus neurodevelopment. Healthcare providers should encourage a responsive feeding approach, even in preterm infants, guided by infants' physiological needs, hunger and satiety once they exhibit feeding cues. This approach respects the child's developmental needs and encourages healthy eating habits, fostering positive parent-child feeding relationships, and ultimately allowing the child to grow and develop to their full potential without compromising their long-term health outcomes.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 2","pages":"Article 101636"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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