Background Adequate postnatal nutrition and growth are essential for optimal neurodevelopment in VLBW infants. In an effort to optimize nutrition, early TPN implementation is recommended while enteral nutrition is achieved. However, excessive caloric intake could result in disproportionate accretion of body fat leading to metabolic syndrome later in life.
Aim To identify the influence of early postnatal nutrition on body fat composition in VLBW infants.
Design/methods We included all infants admitted to our NICU from July 30, 2011 to December 31, 2011 with a birth weight ≤ 1500 grams that survived at least 4 weeks and received TPN. We excluded infants with major congenital anomalies. Body composition was measured weekly using an air displacement plethysmograph (PeaPod, CosMed).
Results Twenty two infants met inclusion criteria. Over 90 measurements were obtained. TPN days ranged from 5 to 39 days. Seventeen infants (77%) received TPN for less than 21 days of TPN. Their mean percent of body fat was 10.9%, significantly lower than the 22% measured in those babies on ≥ 21 days on TPN.
Conclusion In our population of VLBW, those who received TPN for longer than 3 weeks have a significant increase in body fat composition. This could result in increased risk for metabolic syndrome in early adulthood in this population. Our eagerness to avoid postnatal malnutrition could lead to an iatrogenic neonatal origin of adult disease. We are currently analyzing potential confounders and the TPN composition associated with these findings.