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O-085 Dietary Protein In The Very-low-birth-weight Infant: Multicenter Randomised Controlled Trial To Evaluate The Effects Of Dietary Protein Level On Growth
  1. R Cooke1,
  2. N Embleton2,
  3. J Rigo3,
  4. JC Picaud4,
  5. EE Ziegler5,
  6. P Steenhout6,
  7. F Haschke7
  1. 1Neonatal-Perinatal Medicine, Cardinal Glennon Children’s Hospital, St. Louis, USA
  2. 2Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
  3. 3Neonatal Unit, University of Liège, Liège, Belgium
  4. 4Neonatology Service, Hôpital de La Croix Rousse, Lyon, France
  5. 5Department of Pediatrics, University of Iowa, Iowa City, USA
  6. 6Clinical Development Unit, Nestec Ltd, Vevey, Switzerland
  7. 7Nestlé Nutrition Institute, Nestlé S. A., Vevey, Switzerland


Background Several studies suggest that formulas with protein content of 3.0 g/100 kcal do not fully meet the protein needs of preterm very-low-birth-weight infants (VLBWI). This study compared growth, protein-energy status and metabolic status in VLBWI fed either a standard- (Std-Pro: 3.0 g/100 kcal) or high- (Hi-Pro: 3.6 g/100 kcal) protein infant formula.

Methods Once enteral feeding tolerance was established, infants were randomised to be fed either Std-Pro or Hi-Pro formula for a minimum period of 3 weeks. Dietary intake, serum chemistries and growth were closely monitored during the study. Data were analysed on an intention-to-treat basis using a combination of linear mixed model and ANOVA. Results were considered significant at p < 0.05.

Results Sixty-nine infants were enrolled, 51 completed the study. No differences were detected in demographics or energy intakes but protein intake was greater in infants fed Hi-Pro (mean difference: +0.7 g/kg/day, p < 0.0001). No differences were detected in weight gain or body weight but increased protein intake was paralleled by increased blood urea nitrogen (p < 0.001). No differences were detected in weight z-scores but scores in both groups paralleled that in utero. Length z-scores were greater in infants fed Hi-Pro (p < 0.05). As the study progressed, length z-scores did not change in infants fed Hi-Pro, closely paralleling that in utero, but decreased significantly in infants fed Std-Pro (p < 0.0001).

Conclusion A dietary protein intake of 3.6 g/100 kcal meets energy and protein needs while an intake of 3.0 g/100 kcal meets energy but not protein needs in rapidly growing preterm VLBWI.

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