OBJECTIVES: To review the current literature and develop consensus conclusions and recommendations on nutrient intakes and nutritional practice in preterm infants with birthweight <1800 g. METHODS: The European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee of Nutrition (CoN) led a process that included CoN members and invited experts. Invited experts with specific expertise were chosen to represent as broad a geographical spread as possible. A list of topics was developed, and individual leads were assigned to topics along with other members, who reviewed the current literature. A single face-to-face meeting was held in February 2020. Provisional conclusions and recommendations were developed between 2020 and 2021, and these were voted on electronically by all members of the working group between 2021 and 2022. Where >90% consensus was not achieved, online discussion meetings were held, along with further voting until agreement was reached. RESULTS: In general, there is a lack of strong evidence for most nutrients and topics. The summary paper is supported by additional supplementary digital content that provide a fuller explanation of the literature and relevant physiology: introduction and overview; human milk reference data; intakes of water, protein, energy, lipid, carbohydrate, electrolytes, minerals, trace elements, water soluble vitamins, and fat soluble vitamins; feeding mode including mineral enteral feeding, feed advancement, management of gastric residuals, gastric tube placement and bolus or continuous feeding; growth; breastmilk buccal colostrum, donor human milk, and risks of cytomegalovirus infection; hydrolyzed protein and osmolality; supplemental bionutrients; and use of breastmilk fortifier. CONCLUSIONS: We provide updated ESPGHAN CoN consensus-based conclusions and recommendations on nutrient intakes and nutritional management for preterm infants.

Amsterdam UMC University of Amsterdam Vrije Universiteit Emma Children's Hospital Amsterdam The Netherlands

APHP Necker Enfants Malades Hospital Paris University Paris France

From the Newcastle Hospitals NHS Trust and Newcastle University Newcastle upon Tyne UK

H C Andersen Children's Hospital Odense University Hospital and University of Southern Denmark Odense Denmark

Polytechnic University of Marche and Division of Neonatology Ospedali Riuniti Ancona Ancona Italy

the Department of Clinical Pharmacology Medical University of Vienna Vienna Austria

the Department of Clinical Sciences Paediatrics Umeå University Umeå Sweden

the Department of General Paediatrics and Neonatology University Hospital of Saarland Homburg Germany

the Department of Health Management Neu Ulm University of Applied Sciences Neu Ulm Germany

the Department of Health Sciences University of Milan Milan Italy

the Department of Medical and Surgical Sciences University of Foggia Foggia Italy

the Department of Neonatal Intensive Care Oslo University Hospital Oslo Norway

the Department of Neonatal Medicine University Hospital Southampton NHS Trust Southampton UK

the Department of Paediatric Gastroenterology Great Ormond Street Hospital for Children NHS Foundation Trust London UK

the Department of Paediatrics Ospedale dei Bambini Vittore Buzzi Milan Italy

the Department of Paediatrics University Hospital Motol Prague Czech Republic

the Department of Pediatrics Neonatology Amsterdam UMC Emma Children's Hospital University of Amsterdam Vrije Universiteit Amsterdam Amsterdam The Netherlands

the Department of Pediatrics Neonatology La Paz University Hospital Autonoma University of Madrid Madrid Spain

the Department of Pediatrics Nuremberg General Hospital Paracelsus Medical School Nuremberg Germany

the Department of Pediatrics Ulm University Ulm Germany

the Division of Neonatology Department of Pediatrics Hamilton Health Sciences McMaster University Hamilton Ontario Canada

the Human Nutrition School of Medicine Dentistry and Nursing University of Glasgow Glasgow Royal Infirmary Glasgow UK

the National Institute for Health Research Biomedical Research Centre Southampton University Hospital Southampton NHS Trust and University of Southampton Southampton UK

the Neonatal Unit University of Liège CHR Citadelle Liège Belgium

the Paediatric Gastroenterology Erasmus MC Sophia Children's Hospital Rotterdam The Netherlands

the Paediatric Hepatology Gastroenterology and Transplantation ASST Papa Giovanni XXIIII Bergamo Italy

the Réanimation Néonatale et Pédiatrique Néonatologie CHU La Réunion Saint Pierre France

Komentář v

Eur J Pediatr. 2023 Aug;182(8):3801-3802. doi: 10.1007/s00431-023-05000-5. PubMed

Komentář v

J Pediatr Gastroenterol Nutr. 2023 Nov 1;77(5):e71. doi: 10.1097/MPG.0000000000003915. PubMed

Zobrazit více v PubMed

Bischoff SC, Singer P, Koller M, et al. Standard operating procedures for ESPEN guidelines and consensus papers. Clin Nutr. 2015;34:1043–51.

Mihatsch W, Shamir R, van Goudoever JB, et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: guideline development process for the updated guidelines. Clin Nutr. 2018;37(Pt B):2306–8.

Iacobelli S, Guignard JP. Renal aspects of metabolic acid-base disorders in neonates. Pediatr Nephrol. 2020;35:221–8.

Travers CP, Wang T, Salas AA, et al. Higher- or usual-volume feedings in infants born very preterm: a randomized clinical trial. J Pediatr. 2020;224:66–71 e1.

Rochow N, Fusch G, Muhlinghaus A, et al. A nutritional program to improve outcome of very low birth weight infants. Clin Nutr. 2012;31:124–31.

Joosten K, Embleton N, Yan W, et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Energy. Clin Nutr. 2018;37(Pt B):2309–14.

Towers HM, Schulze KF, Ramakrishnan R, et al. Energy expended by low birth weight infants in the deposition of protein and fat. Pediatr Res. 1997;41(Pt 1):584–9.

Bauer J, Werner C, Gerss J. Metabolic rate analysis of healthy preterm and full-term infants during the first weeks of life. Am J Clin Nutr. 2009;90:1517–24.

Bauer J, Maier K, Hellstern G, et al. Longitudinal evaluation of energy expenditure in preterm infants with birth weight less than 1000 g. Br J Nutr. 2003;89:533–7.

Denne SC, Poindexter B. Differences between metabolism and feeding of preterm and term infants. Thureen PJ, Hay WW, eds. In: Neonatal Nutrition and Metabolism. 2nd ed. Cambridge University Press; 2006.

Bauer J, Maier K, Linderkamp O, et al. Effect of caffeine on oxygen consumption and metabolic rate in very low birth weight infants with idiopathic apnea. Pediatrics. 2001;107:660–3.

Abranches AD, Soares FVM, Villela LD, et al. Energy expenditure, growth, and nutritional therapy in appropriate and small for gestational age preterm infants. J Pediatr (Rio J). 2018;94:652–7.

Bell EF, Johnson KJ, Dove EL. Effect of body position on energy expenditure of preterm infants as determined by simultaneous direct and indirect calorimetry. Am J Perinatol. 2017;34:493–8.

Roberts SB, Young VR. Energy costs of fat and protein deposition in the human infant. Am J Clin Nutr. 1988;48:951–5.

Reichman BL, Chessex P, Putet G, et al. Partition of energy metabolism and energy cost of growth in the very low-birth-weight infant. Pediatrics. 1982;69:446–51.

Putet G, Senterre J, Rigo J, et al. Nutrient balance, energy utilization, and composition of weight gain in very-low-birth-weight infants fed pooled human milk or a preterm formula. J Pediatr. 1984;105:79–85.

Romera G, Figueras J, Rodriguez-Miguelez JM, et al. Energy intake, metabolic balance and growth in preterm infants fed formulas with different nonprotein energy supplements. J Pediatr Gastroenterol Nutr. 2004;38:407–13.

Agostoni C, Buonocore G, Carnielli VP, et al. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010;50:85–91.

Rigo J, Hascoet JM, Billeaud C, et al. Growth and nutritional biomarkers of preterm infants fed a new powdered human milk fortifier: a randomized trial. J Pediatr Gastroenterol Nutr. 2017;65:e83–93.

Shah SD, Dereddy N, Jones TL, et al. Early versus delayed human milk fortification in very low birth weight infants-a randomized controlled trial. J Pediatr. 2016;174:126–31 e1.

Maas C, Mathes M, Bleeker C, et al. Effect of increased enteral protein intake on growth in human milk-fed preterm infants: a randomized clinical trial. JAMA Pediatr. 2017;171:16–22.

Arslanoglu S, Moro GE, Ziegler EE. Adjustable fortification of human milk fed to preterm infants: does it make a difference? J Perinatol. 2006;26:614–21.

Brumberg HL, Kowalski L, Troxell-Dorgan A, et al. Randomized trial of enteral protein and energy supplementation in infants less than or equal to 1250 g at birth. J Perinatol. 2010;30:517–21.

Bulut O, Coban A, Uzunhan O, et al. Effects of targeted versus adjustable protein fortification of breast milk on early growth in very low-birth-weight preterm infants: a randomized clinical trial. Nutr Clin Pract. 2020;35:335–43.

McLeod G, Sherriff J, Hartmann PE, et al. Comparing different methods of human breast milk fortification using measured v. assumed macronutrient composition to target reference growth: a randomised controlled trial. Br J Nutr. 2016;115:431–9.

de Halleux V, Pieltain C, Senterre T, et al. Growth benefits of own mother’s milk in preterm infants fed daily individualized fortified human milk. Nutrients. 2019;11:772.

Senterre T, Rigo J. Optimizing early nutritional support based on recent recommendations in VLBW infants and postnatal growth restriction. J Pediatr Gastroenterol Nutr. 2011;53:536–42.

Christmann V, Visser R, Engelkes M, et al. The enigma to achieve normal postnatal growth in preterm infants—using parenteral or enteral nutrition? Acta Paediatr. 2013;102:471–9.

Hu F, Tang Q, Wang Y, et al. Analysis of nutrition support in very low-birth-weight infants with extrauterine growth restriction. Nutr Clin Pract. 2019;34:436–43.

Olsen IE, Harris CL, Lawson ML, et al. Higher protein intake improves length, not weight, z scores in preterm infants. J Pediatr Gastroenterol Nutr. 2014;58:409–16.

Collins CT, Chua MC, Rajadurai VS, et al. Higher protein and energy intake is associated with increased weight gain in pre-term infants. J Paediatr Child Health. 2010;46:96–102.

Coviello C, Keunen K, Kersbergen KJ, et al. Effects of early nutrition and growth on brain volumes, white matter microstructure, and neurodevelopmental outcome in preterm newborns. Pediatr Res. 2018;83:102–10.

Kadioglu Simsek G, Alyamac Dizdar E, Arayici S, et al. Comparison of the effect of three different fortification methods on growth of very low birth weight infants. Breastfeed Med. 2019;14:63–8.

McLeod G, Simmer K, Sherriff J, et al. Feasibility study: assessing influence of macronutrient intakes on preterm body composition, using air displacement plethysmography. J Paediatr Child Health. 2015;51:862–9.

Peiler A, Woelfle J, Stutte S, et al. Postnatal nutrition in extremely low birth weight infants and its impact on growth until the age of 6 years. Acta Paediatr. 2014;103:e61–8.

Johnson MJ, Wootton SA, Leaf AA, et al. Preterm birth and body composition at term equivalent age: a systematic review and meta-analysis. Pediatrics. 2012;130:e640–9.

Hamatschek C, Yousuf EI, Mollers LS, et al. Fat and fat-free mass of preterm and term infants from birth to six months: a review of current evidence. Nutrients. 2020;12.

Costa-Orvay JA, Figueras-Aloy J, Romera G, et al. The effects of varying protein and energy intakes on the growth and body composition of very low birth weight infants. Nutr J. 2011;10:140.

Kashyap S, Ohira-Kist K, Abildskov K, et al. Effects of quality of energy intake on growth and metabolic response of enterally fed low-birth-weight infants. Pediatr Res. 2001;50:390–7.

Kashyap S, Towers HM, Sahni R, et al. Effects of quality of energy on substrate oxidation in enterally fed, low-birth-weight infants. Am J Clin Nutr. 2001;74:374–80.

Wu G. Amino acids: metabolism, functions, and nutrition. Amino Acids. 2009;37:1–17.

Embleton ND, van den Akker CHP. Protein intakes to optimize outcomes for preterm infants. Semin Perinatol. 2019;43:151154.

van Goudoever JB, Vlaardingerbroek H, van den Akker CH, et al. Amino acids and proteins. World Rev Nutr Diet. 2014;110:49–63.

Ziegler EE, O’Donnell AM, Nelson SE, et al. Body composition of the reference fetus. Growth. 1976;40:329–41.

Ziegler EE, Thureen PJ, Carlson SJ. Aggressive nutrition of the very low birthweight infant. Clin Perinatol. 2002;29:225–44.

Gidrewicz DA, Fenton TR. A systematic review and meta-analysis of the nutrient content of preterm and term breast milk. BMC Pediatr. 2014;14:216.

Mimouni FB, Lubetzky R, Yochpaz S, et al. Preterm human milk macronutrient and energy composition: a systematic review and meta-analysis. Clin Perinatol. 2017;44:165–72.

Boyce C, Watson M, Lazidis G, et al. Preterm human milk composition: a systematic literature review. Br J Nutr. 2016;116:1033–45.

Koletzko B, Lapillonne A. Lipid requirements of preterm infants. World Rev Nutr Diet. 2021;122:89–102.

Grote V, Verduci E, Scaglioni S, et al. Breast milk composition and infant nutrient intakes during the first 12 months of life. Eur J Clin Nutr. 2016;70:250–6.

Jensen CL, Lapillonne A. Docosahexaenoic acid and lactation. Prostaglandins Leukot Essent Fatty Acids. 2009;81:175–8.

Lapillonne A, Groh-Wargo S, Gonzalez CH, et al. Lipid needs of preterm infants: updated recommendations. J Pediatr. 2013;162(Suppl):S37–47.

Crawford M. Placental delivery of arachidonic and docosahexaenoic acids: implications for the lipid nutrition of preterm infants. Am J Clin Nutr. 2000;71:275S–84S.

Bernard JY, De Agostini M, Forhan A, et al. The dietary n6:n3 fatty acid ratio during pregnancy is inversely associated with child neurodevelopment in the EDEN mother-child cohort. J Nutr. 2013;143:1481–8.

Kitamura T, Kitamura Y, Hamano H, et al. The ratio of docosahexaenoic acid and arachidonic acid in infant formula influences the fatty acid composition of the erythrocyte membrane in low-birth-weight infants. Ann Nutr Metab. 2016;68:103–12.

Rigourd V, Lopera I, Cata F, et al. Role of daily milk volume and period of lactation in nutrient content of human milk: results from a prospective study. Nutrients. 2020;12.

Rochow N, Moller S, Fusch G, et al. Levels of lipids in preterm infants fed breast milk. Clin Nutr. 2010;29:94–9.

Stoltz Sjostrom E, Ohlund I, Tornevi A, et al. Intake and macronutrient content of human milk given to extremely preterm infants. J Hum Lact. 2014;30:442–9.

Kien CL. Digestion, absorption, and fermentation of carbohydrates in the newborn. Clin Perinatol. 1996;23:211–28.

Shulman RJ, Schanler RJ, Lau C, et al. Early feeding, feeding tolerance, and lactase activity in preterm infants. J Pediatr. 1998;133:645–9.

Shulman RJ, Feste A, Ou C. Absorption of lactose, glucose polymers, or combination in premature infants. J Pediatr. 1995;127:626–31.

Griffin MP, Hansen JW. Can the elimination of lactose from formula improve feeding tolerance in premature infants? J Pediatr. 1999;135:587–92.

Kien CL, Liechty EA, Mullett MD. Effects of lactose intake on nutritional status in premature infants. J Pediatr. 1990;116:446–9.

Kien CL, McClead RE, Cordero L Jr. Effects of lactose intake on lactose digestion and colonic fermentation in preterm infants. J Pediatr. 1998;133:401–5.

Mihatsch WA, von Schoenaich P, Fahnenstich H, et al. Randomized, multicenter trial of two different formulas for very early enteral feeding advancement in extremely-low-birth-weight infants. J Pediatr Gastroenterol Nutr. 2001;33:155–9.

Stathos TH, Shulman RJ, Schanler RJ, et al. Effect of carbohydrates on calcium absorption in premature infants. Pediatr Res. 1996;39(Pt 1):666–70.

Farrag HM, Cowett RM. Glucose homeostasis in the micropremie. Clin Perinatol. 2000;27:1–22, v.

Van Kempen AA, Romijn JA, Ruiter AF, et al. Adaptation of glucose production and gluconeogenesis to diminishing glucose infusion in preterm infants at varying gestational ages. Pediatr Res. 2003;53:628–34.

Zamir I, Tornevi A, Abrahamsson T, et al. Hyperglycemia in extremely preterm infants-insulin treatment, mortality and nutrient intakes. J Pediatr. 2018;200:104–110.e1.

Stensvold HJ, Strommen K, Lang AM, et al. Early enhanced parenteral nutrition, hyperglycemia, and death among extremely low-birth-weight infants. JAMA Pediatr. 2015;169:1003–10.

Collins CT, Gibson RA, Miller J, et al. Carbohydrate intake is the main determinant of growth in infants born <33 weeks’ gestation when protein intake is adequate. Nutrition. 2008;24:451–7.

Zamir I, Stoltz Sjostrom E, Edstedt Bonamy AK, et al. Postnatal nutritional intakes and hyperglycemia as determinants of blood pressure at 6.5 years of age in children born extremely preterm. Pediatr Res. 2019;86:115–21.

Amissah EA, Brown J, Harding JE. Carbohydrate supplementation of human milk to promote growth in preterm infants. Cochrane Database Syst Rev. 2018;8:CD000280.

Klingenberg C, Muraas FK, Isaksen CE, et al. Growth and neurodevelopment in very preterm infants receiving a high enteral volume-feeding regimen – a population-based cohort study. J Matern Fetal Neonatal Med. 2019;32:1664–72.

Thomas N, Cherian A, Santhanam S, et al. A randomized control trial comparing two enteral feeding volumes in very low birth weight babies. J Trop Pediatr. 2012;58:55–8.

Ziegler EE, O’Donnell AM, Nelson SE, et al. Body composition of the reference fetus. Growth. 1976;40:329–41.

Fusch C, Jochum F. Water, sodium, potassium and chloride. Koletzko B, Poindexter B, Uauy R, eds. In: Nutritional Care of Preterm Infants: Scientific Basis and Practical Guidelines. Basel: Karger; 2014.

Gubhaju L, Sutherland MR, Horne RS, et al. Assessment of renal functional maturation and injury in preterm neonates during the first month of life. Am J Physiol Renal Physiol. 2014;307:F149–158.

Suarez-Rivera M, Bonilla-Felix M. Fluid and electrolyte disorders in the newborn: sodium and potassium. Curr Pediatr Rev. 2014;10:115–22.

Segar DE, Segar EK, Harshman LA, et al. Physiological approach to sodium supplementation in preterm infants. Am J Perinatol. 2018;35:994–1000.

Ertl T, Sulyok E, Nemeth M, et al. Hormonal control of sodium content in human milk. Acta Paediatr Acad Sci Hung. 1982;23:309–18.

Becker GE, Smith HA, Cooney F. Methods of milk expression for lactating women. Cochrane Database Syst Rev. 2016;9:CD006170.

Codo CRB, Caldas JPS, Peixoto RRA, et al. Electrolyte and mineral composition of term donor human milk before and after pasteurization and of raw milk of preterm mothers. Rev Paul Pediatr. 2018;36:141–7.

Chandran S, Chua MC, Lin W, et al. Medications that increase osmolality and compromise the safety of enteral feeding in preterm infants. Neonatology. 2017;111:309–16.

Bauer J, Gerss J. Longitudinal analysis of macronutrients and minerals in human milk produced by mothers of preterm infants. Clin Nutr. 2011;30:215–20.

Grossman H, Duggan E, McCamman S, et al. The dietary chloride deficiency syndrome. Pediatrics. 1980;66:366–74.

Roy S 3rd, Arant BS Jr. Hypokalemic metabolic alkalosis in normotensive infants with elevated plasma renin activity and hyperaldosteronism: role of dietary chloride deficiency. Pediatrics. 1981;67:423–9.

Klein CJ. Nutrient requirements for preterm infant formulas. J Nutr. 2002;132(Suppl 1):1395S–577S.

Iacobelli S, Kermorvant-Duchemin E, Bonsante F, et al. Chloride balance in preterm infants during the first week of life. Int J Pediatr. 2012;2012:931597.

Besouw M, Bockenhauer D. Potassium metabolism. Oh W, ed. In: Nephrology and Fluid/Electrolyte Physiology. Neonatology Questions and Controversies. 3rd ed. Philadelphia: Elsevier; 2018.

Bonsante F, Iacobelli S, Chantegret C, et al. The effect of parenteral nitrogen and energy intake on electrolyte balance in the preterm infant. Eur J Clin Nutr. 2011;65:1088–93.

Moltu SJ, Strommen K, Blakstad EW, et al. Enhanced feeding in very-low-birth-weight infants may cause electrolyte disturbances and septicemia—a randomized, controlled trial. Clin Nutr. 2013;32:207–12.

Bonsante F, Iacobelli S, Latorre G, et al. Initial amino acid intake influences phosphorus and calcium homeostasis in preterm infants—it is time to change the composition of the early parenteral nutrition. PLoS One. 2013;8:e72880.

Pieltain C, de Halleux V, Senterre T, et al. Prematurity and bone health. World Rev Nutr Diet. 2013;106:181–8.

Committee on Nutrition of the Preterm Infant ESoPGaN. Nutrition and feeding of preterm infants. Acta Paediatr Scand Suppl. 1987;336:1–14.

Rustico SE, Calabria AC, Garber SJ. Metabolic bone disease of prematurity. J Clin Transl Endocrinol. 2014;1:85–91.

Tsang RC, Uauy R, Koletzko B, et al. Nutritional Needs of the Preterm Infant. Scientific Basis and Practical Guidelines. Cincinnati, Ohio: Digital Educational Publishing; 2005.

Abrams SA, Committee on N. Calcium and vitamin D requirements of enterally fed preterm infants. Pediatrics. 2013;131:e1676–83.

Mimouni FB, Mandel D, Lubetzky R, et al. Calcium, phosphorus, magnesium and vitamin D requirements of the preterm infant. World Rev Nutr Diet. 2014;110:140–51.

Widdowson E, Dickerson J. The composition of the body as a whole. Comar C, Bronner F, eds. In: Mineral Metabolism. New York: Academic Press; 1961.

Sparks JW. Human intrauterine growth and nutrient accretion. Semin Perinatol. 1984;8:74–93.

Rigo J, De Curtis M, Pieltain C, et al. Bone mineral metabolism in the micropremie. Clin Perinatol. 2000;27:147–70.

Rigo J, Pieltain C, Viellevoye R, et al. Calcium and phosphorus homeostasis: pathophysiology. Buenocore G, Bracci R, Weindling M, eds. In: Neonatology. A Practical Approach to Neonatal Diseases. Rome: Springer; 2012.

Koo WW, Warren L. Calcium and bone health in infants. Neonatal Netw. 2003;22:23–37.

Cooke R, Hollis B, Conner C, et al. Vitamin D and mineral metabolism in the very low birth weight infant receiving 400 IU of vitamin D. J Pediatr. 1990;116:423–8.

Andrieux C, Sacquet E. Effects of Maillard’s reaction products on apparent mineral absorption in different parts of the digestive tract. The role of microflora. Reprod Nutr Dev. 1984;24:379–86.

Seiquer I, Delgado-Andrade C, Haro A, et al. Assessing the effects of severe heat treatment of milk on calcium bioavailability: in vitro and in vivo studies. J Dairy Sci. 2010;93:5635–43.

Rigo J, Salle BL, Picaud JC, Putet G, Senterre J. Nutritional evaluation of protein hydrolysate formulas. Eur J Clin Nutr. 1995;49:S26–38.

Picaud JC, Lapillonne A, Rigo J, et al. Nitrogen utilization and bone mineralization in very low birth weight infants fed partially hydrolyzed preterm formula. Semin Perinatol. 2002;26:439–46.

Carnielli VP, Luijendijk IH, van Goudoever JB, et al. Feeding premature newborn infants palmitic acid in amounts and stereoisomeric position similar to that of human milk: effects on fat and mineral balance. Am J Clin Nutr. 1995;61:1037–42.

Lucas-Herald A, Butler S, Mactier H, et al. Prevalence and characteristics of rib fractures in ex-preterm infants. Pediatrics. 2012;130:1116–9.

O’Reilly P, Saviani M, Tou A, et al. Do preterm bones still break? Incidence of rib fracture and osteopenia of prematurity in very low birth weight infants. J Paediatr Child Health. 2020;56:959–63.

Fewtrell MS. Does early nutrition program later bone health in preterm infants? Am J Clin Nutr. 2011;94:1870S–3S.

Mihatsch W, Fewtrell M, Goulet O, et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: calcium, phosphorus and magnesium. Clin Nutr. 2018;37(Pt B):2360–5.

Rigo J, Pieltain C, Christmann V, et al. Serum magnesium levels in preterm infants are higher than adult levels: a systematic literature review and meta-analysis. Nutrients. 2017;9.

Mills RJ, Davies MW. Enteral iron supplementation in preterm and low birth weight infants. Cochrane Database Syst Rev. 2012:CD005095.

Jin HX, Wang RS, Chen SJ, et al. Early and late iron supplementation for low birth weight infants: a meta-analysis. Ital J Pediatr. 2015;41:16.

Jasani B, Torgalkar R, Ye XY, et al. Association of umbilical cord management strategies with outcomes of preterm infants: a systematic review and network meta-analysis. JAMA Pediatr. 2021;175:e210102.

Domellof M. Meeting the iron needs of low and very low birth weight infants. Ann Nutr Metab. 2017;71:16–23.

Alm S, Stoltz Sjostrom E, Nilsson Sommar J, et al. Erythrocyte transfusions increased the risk of elevated serum ferritin in very low birthweight infants and were associated with altered longitudinal growth. Acta Paediatr. 2020;109:1354–60.

Domellof M, Georgieff MK. Postdischarge iron requirements of the preterm infant. J Pediatr. 2015;167:S31–5.

Hambidge M. Human zinc deficiency. J Nutr. 2000;130(Suppl):1344S–9S.

Bhatia J, Griffin I, Anderson D, et al. Selected macro/micronutrient needs of the routine preterm infant. J Pediatr. 2013;162:S48–55.

(AAP) AAoP. Kleinman RE, ed. In: Pediatric Nutrition Handbook. 6th ed; 2009.

Diaz-Gomez NM, Domenech E, Barroso F, et al. The effect of zinc supplementation on linear growth, body composition, and growth factors in preterm infants. Pediatrics. 2003;111(Pt 1):1002–9.

Friel JK, Andrews WL, Matthew JD, et al. Zinc supplementation in very-low-birth-weight infants. J Pediatr Gastroenterol Nutr. 1993;17:97–104.

Staub E, Evers K, Askie LM. Enteral zinc supplementation for prevention of morbidity and mortality in preterm neonates. Cochrane Database Syst Rev. 2021;3:CD012797.

Alshaikh B, Abo Zeed M, Yusuf K, Guin M, Fenton T. Effect of enteral zinc supplementation on growth and neurodevelopment of preterm infants: a systematic review and meta-analysis. J Perinatol. 2022;42:430–9.

Wulf K, Wilhelm A, Spielmann M, et al. Frequency of symptomatic zinc deficiency in very low birth weight infants. Klin Padiatr. 2013;225:13–7.

EFSA. Dietary reference values for nutrients; Summary report. EFSA supporting publication; 2017:e15121. Available at: https://efsa.onlinelibrary.wiley.com/toc/23978325/2017/14/12 .

Mactier H, Weaver LT. Vitamin A and preterm infants: what we know, what we don’t know, and what we need to know. Arch Dis Child Fetal Neonatal Ed. 2005;90:F103–8.

Mactier H. Vitamin A for preterm infants; where are we now? Semin Fetal Neonatal Med. 2013;18:166–71.

Massaro D, Massaro GD. Lung development, lung function, and retinoids. N Engl J Med. 2010;362:1829–31.

Tammela O, Aitola M, Ikonen S. Cord blood concentrations of vitamin A in preterm infants. Early Hum Dev. 1999;56:39–47.

Mactier H, McCulloch DL, Hamilton R, et al. Vitamin A supplementation improves retinal function in infants at risk of retinopathy of prematurity. J Pediatr. 2012;160:954–959 e1.

Darlow BA, Graham PJ, Rojas-Reyes MX. Vitamin A supplementation to prevent mortality and short- and long-term morbidity in very low birth weight infants. Cochrane Database Syst Rev. 2016:CD000501.

Wardle SP, Hughes A, Chen S, et al. Randomised controlled trial of oral vitamin A supplementation in preterm infants to prevent chronic lung disease. Arch Dis Child Fetal Neonatal Ed. 2001;84:F9–F13.

Basu S, Khanna P, Srivastava R, et al. Oral vitamin A supplementation in very low birth weight neonates: a randomized controlled trial. Eur J Pediatr. 2019;178:1255–65.

Rakshasbhuvankar AA, Simmer K, Patole SK, et al. Enteral vitamin A for reducing severity of bronchopulmonary dysplasia: a randomized trial. Pediatrics. 2021;147:e2020009985.

Ye Y, Yang X, Zhao J, et al. Early vitamin A supplementation for prevention of short-term morbidity and mortality in very-low-birth-weight infants: a systematic review and meta-analysis. Front Pediatr. 2022;10:788409.

Biesalski HK. Vitamin D recommendations: beyond deficiency. Ann Nutr Metab. 2011;59:10–6.

Delvin EE, Salle BL, Glorieux FH, et al. Vitamin D metabolism in preterm infants: effect of a calcium load. Biol Neonate. 1988;53:321–6.

Delvin EE, Lopez V, Levy E, et al. Developmental expression of calcitriol receptors, 9-kilodalton calcium-binding protein, and calcidiol 24-hydroxylase in human intestine. Pediatr Res. 1996;40:664–70.

Salle BL, Delvin EE, Lapillonne A, et al. Perinatal metabolism of vitamin D. Am J Clin Nutr. 2000;71:1317S–24S.

Backstrom MC, Maki R, Kuusela AL, et al. Randomised controlled trial of vitamin D supplementation on bone density and biochemical indices in preterm infants. Arch Dis Child Fetal Neonatal Ed. 1999;80:F161–166.

Braegger C, Campoy C, Colomb V, et al. Vitamin D in the healthy European paediatric population. J Pediatr Gastroenterol Nutr. 2013;56:692–701.

Vierge M, Laborie S, Bertholet-Thomas A, et al. [Neonatal intoxication to vitamin D in premature babies: A series of 16 cases]. Arch Pediatr. 2017;24:817–24.

Natarajan CK, Sankar MJ, Agarwal R, et al. Trial of daily vitamin D supplementation in preterm infants. Pediatrics. 2014;133:e628–634.

Anderson-Berry A, Thoene M, Wagner J, et al. Randomized trial of two doses of vitamin D3 in preterm infants <32 weeks: dose impact on achieving desired serum 25(OH)D3 in a NICU population. PLoS One. 2017;12:e0185950.

Bozkurt O, Uras N, Sari FN, et al. Multi-dose vitamin D supplementation in stable very preterm infants: prospective randomized trial response to three different vitamin D supplementation doses. Early Hum Dev. 2017;112:54–9.

Munshi UK, Graziano PD, Meunier K, et al. Serum 25 hydroxy vitamin D levels in very low birth weight infants receiving oral vitamin D supplementation. J Pediatr Gastroenterol Nutr. 2018;66:676–9.

Fort P, Salas AA, Nicola T, et al. A comparison of 3 vitamin D dosing regimens in extremely preterm infants: a randomized controlled trial. J Pediatr. 2016;174:132–138 e1.

Thibeault DW. The precarious antioxidant defenses of the preterm infant. Am J Perinatol. 2000;17:167–81.

Perrone S, Salvi G, Bellieni CV, et al. Oxidative stress and nutrition in the preterm newborn. J Pediatr Gastroenterol Nutr. 2007;45:S178–182.

Kositamongkol S, Suthutvoravut U, Chongviriyaphan N, et al. Vitamin A and E status in very low birth weight infants. J Perinatol. 2011;31:471–6.

Greer FR. Fat-soluble vitamin supplements for enterally fed preterm infants. Neonatal Netw. 2001;20:7–11.

Bell EF, Hansen NI, Brion LP, et al. Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth. Pediatrics. 2013;132:e1626–33.

Kitajima H, Kanazawa T, Mori R, et al. Long-term alpha-tocopherol supplements may improve mental development in extremely low birthweight infants. Acta Paediatr. 2015;104:e82–89.

Bell EF. Upper limit of vitamin E in infant formulas. J Nutr. 1989;119:1829–31.

Nutrient needs and feeding of premature infants. Nutrition Committee, Canadian Paediatric Society. CMAJ. 1995;152:1765–85.

Pichler E, Pichler L. The neonatal coagulation system and the vitamin K deficiency bleeding – a mini review. Wien Med Wochenschr. 2008;158(13–14):385–95.

Clarke P, Mitchell SJ, Wynn R, et al. Vitamin K prophylaxis for preterm infants: a randomized, controlled trial of 3 regimens. Pediatrics. 2006;118:e1657–1666.

Clarke P. Vitamin K prophylaxis for preterm infants. Early Hum Dev. 2010;86:17–20.

Shearer MJ. Vitamin K deficiency bleeding (VKDB) in early infancy. Blood Rev. 2009;23:49–59.

Fiesack S, Smits A, Rayyan M, et al. Belgian consensus recommendations to prevent vitamin K deficiency bleeding in the term and preterm infant. Nutrients. 2021;13.

Greer FR. Vitamin K the basics—what’s new? Early Hum Dev. 2010;86:43–7.

Greene HL, Hambidge KM, Schanler R, et al. Guidelines for the use of vitamins, trace elements, calcium, magnesium, and phosphorus in infants and children receiving total parenteral nutrition: report of the Subcommittee on Pediatric Parenteral Nutrient Requirements from the Committee on Clinical Practice Issues of the American Society for Clinical Nutrition. Am J Clin Nutr. 1988;48:1324–42.

Salas AA, Kabani N, Travers CP, et al. Short versus extended duration of trophic feeding to reduce time to achieve full enteral feeding in extremely preterm infants: an observational study. Neonatology. 2017;112:211–6.

McClure RJ. Trophic feeding of the preterm infant. Acta Paediatr Suppl. 2001;90:19–21.

Morgan J, Bombell S, McGuire W. Early trophic feeding versus enteral fasting for very preterm or very low birth weight infants. Cochrane Database Syst Rev. 2013:CD000504.

Morgan J, Young L, McGuire W. Delayed introduction of progressive enteral feeds to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst Rev. 2014:CD001970.

Bozkurt O, Alyamac Dizdar E, Bidev D, Sari FN, Uras N, Oguz SS. Prolonged minimal enteral nutrition versus early feeding advancements in preterm infants with birth weight </=1250 g: a prospective randomized trial. J Matern Fetal Neonatal Med. 2020;1:7.

Salas AA, Li P, Parks K, et al. Early progressive feeding in extremely preterm infants: a randomized trial. Am J Clin Nutr. 2018;107:365–70.

Salas AA, Li P, Parks K, et al. Can early progressive feeding increase the number of days alive on full enteral feeding in extremely preterm infants? J Invest Med. 2018;66:559.

Oddie SJ, Young L, McGuire W. Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst Rev. 2017;8:CD001241.

Dorling J, Abbott J, Berrington J, et al. Controlled trial of two incremental milk-feeding rates in preterm infants. N Engl J Med. 2019;381:1434–43.

Cavell B. Gastric emptying in infants fed human milk or infant formula. Acta Paediatr Scand. 1981;70:639–41.

Ewer AK, Durbin GM, Morgan ME, et al. Gastric emptying in preterm infants. Arch Dis Child Fetal Neonatal Ed. 1994;71:F24–7.

Perrella SL, Hepworth AR, Gridneva Z, et al. Gastric emptying and curding of pasteurized donor human milk and mother’s own milk in preterm infants. J Pediatr Gastroenterol Nutr. 2015;61:125–9.

Yigit S, Akgoz A, Memisoglu A, et al. Breast milk fortification: effect on gastric emptying. J Matern Fetal Neonatal Med. 2008;21:843–6.

Riskin A, Cohen K, Kugelman A, et al. The impact of routine evaluation of gastric residual volumes on the time to achieve full enteral feeding in preterm infants. J Pediatr. 2017;189:128–34.

Abiramalatha T, Thanigainathan S, Ninan B. Routine monitoring of gastric residual for prevention of necrotising enterocolitis in preterm infants. Cochrane Database Syst Rev. 2019;7:CD012937.

Klingenberg C, Embleton ND, Jacobs SE, et al. Enteral feeding practices in very preterm infants: an international survey. Arch Dis Child Fetal Neonatal Ed. 2012;97:F56–61.

Miller M, Vaidya R, Rastogi D, et al. From parenteral to enteral nutrition: a nutrition-based approach for evaluating postnatal growth failure in preterm infants. JPEN J Parenter Enteral Nutr. 2014;38:489–97.

de Waard M, Li Y, Zhu Y, et al. Time to full enteral feeding for very low-birth-weight infants varies markedly among hospitals worldwide but may not be associated with incidence of necrotizing enterocolitis: the NEOMUNE-NeoNutriNet cohort study. JPEN J Parenter Enteral Nutr. 2019;43:658–67.

Spath C, Zamir I, Sjostrom ES, et al. Use of concentrated parenteral nutrition solutions is associated with improved nutrient intakes and postnatal growth in very low-birth-weight infants. JPEN J Parenter Enteral Nutr. 2020;44:327–36.

Adamkin DH. Early aggressive nutrition: parenteral amino acids and minimal enteral nutrition for extremely low birth weight (<1 000 g) infants. Minerva Pediatr. 2007;59:369–77.

Miller M, Donda K, Bhutada A, et al. Transitioning preterm infants from parenteral nutrition: a comparison of 2 protocols. JPEN J Parenter Enteral Nutr. 2017;41:1371–9.

Brennan AM, Kiely ME, Fenton S, et al. Standardized parenteral nutrition for the transition phase in preterm infants: a bag that fits. Nutrients. 2018;10.

Moltu SJ, Blakstad EW, Strommen K, et al. Enhanced feeding and diminished postnatal growth failure in very-low-birth-weight infants. J Pediatr Gastroenterol Nutr. 2014;58:344–51.

Roggero P, Gianni ML, Orsi A, et al. Implementation of nutritional strategies decreases postnatal growth restriction in preterm infants. PLoS One. 2012;7:e51166.

Butler TJ, Szekely LJ, Grow JL. A standardized nutrition approach for very low birth weight neonates improves outcomes, reduces cost and is not associated with increased rates of necrotizing enterocolitis, sepsis or mortality. J Perinatol. 2013;33:851–7.

Loomis T, Byham-Gray L, Ziegler J, et al. Impact of standardized feeding guidelines on enteral nutrition administration, growth outcomes, metabolic bone disease, and cholestasis in the NICU. J Pediatr Gastroenterol Nutr. 2014;59:93–8.

Jadcherla SR, Dail J, Malkar MB, et al. Impact of process optimization and quality improvement measures on neonatal feeding outcomes at an all-referral neonatal intensive care unit. JPEN J Parenter Enteral Nutr. 2016;40:646–55.

Belling-Dierks F, Glaser K, Wirbelauer J, et al. Does rapid enteral feeding increase intestinal morbidity in very low birth weight infants? A retrospective analysis. J Matern Fetal Neonatal Med. 2017;30:2690–6.

Johnson MJ, Leaf AA, Pearson F, et al. Successfully implementing and embedding guidelines to improve the nutrition and growth of preterm infants in neonatal intensive care: a prospective interventional study. BMJ Open. 2017;7:e017727.

Dutta S, Singh B, Chessell L, et al. Guidelines for feeding very low birth weight infants. Nutrients. 2015;7:423–42.

Barrett CE, Thornton K, Boateng B. A retrospective review of the incidence of necrotizing enterocolitis in very low birth weight neonates before and after the establishment of feeding guidelines. J Invest Med. 2011;59:450–1.

Stocks J. Effect of nasogastric tubes on nasal resistance during infancy. Arch Dis Child. 1980;55:17–21.

Purcell M. Response in the newborn to raised upper airway resistance. Arch Dis Child. 1976;51:602–7.

Tonkin SL, Partridge J, Beach D, et al. The pharyngeal effect of partial nasal obstruction. Pediatrics. 1979;63:261–71.

Watson J, McGuire W. Nasal versus oral route for placing feeding tubes in preterm or low birth weight infants. Cochrane Database Syst Rev. 2013:CD003952.

Lagercrantz H, Edwards D, Henderson-Smart D, et al. Autonomic reflexes in preterm infants. Acta Paediatr Scand. 1990;79:721–8.

Ducrocq J, Cardot V, Tourneux P, et al. Use of the oculocardiac reflex to assess vagal reactivity during quiet sleep in neonates. J Sleep Res. 2006;15:167–73.

de Boer JC, Smit BJ, Mainous RO. Nasogastric tube position and intragastric air collection in a neonatal intensive care population. Adv Neonatal Care. 2009;9:293–8.

Quandt D, Schraner T, Ulrich Bucher H, et al. Malposition of feeding tubes in neonates: is it an issue? J Pediatr Gastroenterol Nutr. 2009;48:608–11.

Arens R, Reichman B. Grooved palate associated with prolonged use of orogastric feeding tubes in premature infants. J Oral Maxillofac Surg. 1992;50:64–5.

Aynsley-Green A, Adrian TE, Bloom SR. Feeding and the development of enteroinsular hormone secretion in the preterm infant: effects of continuous gastric infusions of human milk compared with intermittent boluses. Acta Paediatr Scand. 1982;71:379–83.

Razak A. Two-hourly versus three-hourly feeding in very low-birth-weight infants: a systematic review and meta-analysis. Am J Perinatol. 2020;37:898–906.

Bozzetti V, Paterlini G, De Lorenzo P, et al. Impact of continuous vs bolus feeding on splanchnic perfusion in very low birth weight infants: a randomized trial. J Pediatr. 2016;176:86–92 e2.

Grant J, Denne SC. Effect of intermittent versus continuous enteral feeding on energy expenditure in premature infants. J Pediatr. 1991;118:928–32.

Wang Y, Zhu W, Luo BR. Continuous feeding versus intermittent bolus feeding for premature infants with low birth weight: a meta-analysis of randomized controlled trials. Eur J Clin Nutr. 2020;74:775–83.

Castro M, Asbury M, Shama S, et al. Energy and fat intake for preterm infants fed donor milk is significantly impacted by enteral feeding method. JPEN J Parenter Enteral Nutr. 2019;43:162–5.

Martini S, Aceti A, Furini M, et al. Effect of different tube feeding methods on the delivery of docosahexaenoic and arachidonic acid: an in vitro pilot study. JPEN J Parenter Enteral Nutr. 2019;43:550–6.

Dollberg S, Kuint J, Mazkereth R, et al. Feeding tolerance in preterm infants: randomized trial of bolus and continuous feeding. J Am Coll Nutr. 2000;19:797–800.

Corvaglia L, Martini S, Aceti A, et al. Cardiorespiratory events with bolus versus continuous enteral feeding in healthy preterm infants. J Pediatr. 2014;165:1255–7.

Akintorin SM, Kamat M, Pildes RS, et al. A prospective randomized trial of feeding methods in very low birth weight infants. Pediatrics. 1997;100:E4.

Schanler RJ, Shulman RJ, Lau C, et al. Feeding strategies for premature infants: randomized trial of gastrointestinal priming and tube-feeding method. Pediatrics. 1999;103:434–9.

Toce SS, Keenan WJ, Homan SM. Enteral feeding in very-low-birth-weight infants. A comparison of two nasogastric methods. Am J Dis Child. 1987;141:439–44.

Lau C. Development of suck and swallow mechanisms in infants. Ann Nutr Metab. 2015;66:7–14.

Gewolb IH, Vice FL. Abnormalities in the coordination of respiration and swallow in preterm infants with bronchopulmonary dysplasia. Dev Med Child Neurol. 2006;48:595–9.

Hanin M, Nuthakki S, Malkar MB, et al. Safety and efficacy of oral feeding in infants with BPD on nasal CPAP. Dysphagia. 2015;30:121–7.

Dalgleish SR, Kostecky LL, Blachly N. Eating in “SINC”: Safe Individualized Nipple-Feeding competence, a quality improvement project to explore infant-driven oral feeding for very premature infants requiring noninvasive respiratory support. Neonatal Netw. 2016;35:217–27.

Leibel SL, Castro M, McBride T, et al. Comparison of Continuous positive airway pressure versus High flow nasal cannula for Oral feeding Preterm infants (CHOmP): randomized pilot study. J Matern Fetal Neonatal Med. 2020;1:7.

Ferrara L, Bidiwala A, Sher I, et al. Effect of nasal continuous positive airway pressure on the pharyngeal swallow in neonates. J Perinatol. 2017;37:398–403.

Watson J, McGuire W. Responsive versus scheduled feeding for preterm infants. Cochrane Database Syst Rev. 2015:CD005255.

Foster JP, Psaila K, Patterson T. Non-nutritive sucking for increasing physiologic stability and nutrition in preterm infants. Cochrane Database Syst Rev. 2016;10:CD001071.

Fucile S, McFarland DH, Gisel EG, et al. Oral and nonoral sensorimotor interventions facilitate suck-swallow-respiration functions and their coordination in preterm infants. Early Hum Dev. 2012;88:345–50.

Rustam LB, Masri S, Atallah N, et al. Sensorimotor therapy and time to full oral feeding in <33weeks infants. Early Hum Dev. 2016;99:1–5.

McKechnie AC, Eglash A. Nipple shields: a review of the literature. Breastfeed Med. 2010;5:309–14.

Chow S, Chow R, Popovic M, et al. The use of nipple shields: a review. Front Public Health. 2015;3:236.

Maastrup R, Walloee S, Kronborg H. Nipple shield use in preterm infants: prevalence, motives for use and association with exclusive breastfeeding—results from a national cohort study. PLoS One. 2019;14:e0222811.

Poindexter B. Approaches to growth faltering. Koletzko B, Poindexter B, Uauy R, eds. In: Nutritional Care of Preterm Infants: Scientific Basis and Practical Guidelines. World Rev Nutr Diet. Basel: Karger; 2014.

Lane RH. Fetal programming, epigenetics, and adult onset disease. Clin Perinatol. 2014;41:815–31.

Rochow N, Raja P, Liu K, et al. Physiological adjustment to postnatal growth trajectories in healthy preterm infants. Pediatr Res. 2016;79:870–9.

Landau-Crangle E, Rochow N, Fenton TR, et al. Individualized postnatal growth trajectories for preterm infants. JPEN J Parenter Enteral Nutr. 2018;42:1084–92.

Asbury MR, Unger S, Kiss A, et al. Optimizing the growth of very-low-birth-weight infants requires targeting both nutritional and nonnutritional modifiable factors specific to stage of hospitalization. Am J Clin Nutr. 2019;110:1384–94.

Molony C, Hiscock R, Kaufman J, et al. Growth trajectory of preterm small-for-gestational-age neonates. J Matern Fetal Neonatal Med. 2021;1:7.

Moro GE, Arslanoglu S, Bertino E, et al. XII. Human milk in feeding premature infants: consensus statement. J Pediatr Gastroenterol Nutr. 2015;61:S16–9.

Rochow N, Landau-Crangle E, So HY, et al. Z-score differences based on cross-sectional growth charts do not reflect the growth rate of very low birth weight infants. PLoS One. 2019;14:e0216048.

Toftlund LH, Halken S, Agertoft L, et al. Catch-up growth, rapid weight growth, and continuous growth from birth to 6 years of age in very-preterm-born children. Neonatology. 2018;114:285–93.

Nasuf AWA, Ojha S, Dorling J. Oropharyngeal colostrum in preventing mortality and morbidity in preterm infants. Cochrane Database Syst Rev. 2018;9:CD011921.

Tao J, Mao J, Yang J, et al. Effects of oropharyngeal administration of colostrum on the incidence of necrotizing enterocolitis, late-onset sepsis, and death in preterm infants: a meta-analysis of RCTs. Eur J Clin Nutr. 2020;74:1122–31.

Quigley M, Embleton ND, McGuire W. Formula versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev. 2019;7:CD002971.

Silano M, Milani GP, Fattore G, et al. Donor human milk and risk of surgical necrotizing enterocolitis: a meta-analysis. Clin Nutr. 2019;38:1061–6.

Josephson CD, Caliendo AM, Easley KA, et al. Blood transfusion and breast milk transmission of cytomegalovirus in very low-birth-weight infants: a prospective cohort study. JAMA Pediatr. 2014;168:1054–62.

Omarsdottir S, Casper C, Naver L, et al. Cytomegalovirus infection and neonatal outcome in extremely preterm infants after freezing of maternal milk. Pediatr Infect Dis J. 2015;34:482–9.

Kurath S, Halwachs-Baumann G, Muller W, et al. Transmission of cytomegalovirus via breast milk to the prematurely born infant: a systematic review. Clin Microbiol Infect. 2010;16:1172–8.

Lanzieri TM, Dollard SC, Josephson CD, et al. Breast milk-acquired cytomegalovirus infection and disease in VLBW and premature infants. Pediatrics. 2013;131:e1937–1945.

Stark A, Cantrell S, Greenberg RG, et al. Long-term outcomes after postnatal cytomegalovirus infection in low birthweight preterm infants: a systematic review. Pediatr Infect Dis J. 2021;40:571–81.

Gunkel J, de Vries LS, Jongmans M, et al. Outcome of preterm infants with postnatal cytomegalovirus infection. Pediatrics. 2018;141:e20170635.

Turner KM, Lee HC, Boppana SB, et al. Incidence and impact of CMV infection in very low birth weight infants. Pediatrics. 2014;133:e609–15.

Cossey V, Vanhole C, Eerdekens A, et al. Pasteurization of mother’s own milk for preterm infants does not reduce the incidence of late-onset sepsis. Neonatology. 2013;103:170–6.

De Curtis M, Candusso M, Pieltain C, et al. Effect of fortification on the osmolality of human milk. Arch Dis Child Fetal Neonatal Ed. 1999;81:F141–143.

listed N. Commentary on breast-feeding and infant formulas, including proposed standards for formulas. Pediatrics. 1976;57:278–85.

Ellis ZM, Tan HSG, Embleton ND, et al. Milk feed osmolality and adverse events in newborn infants and animals: a systematic review. Arch Dis Child Fetal Neonatal Ed. 2019;104:F333–40.

Pearson F, Johnson MJ, Leaf AA. Milk osmolality: does it matter? Arch Dis Child Fetal Neonatal Ed. 2013;98:F166–169.

Agarwal R, Singal A, Aggarwal R, et al. Effect of fortification with human milk fortifier (HMF) and other fortifying agents on the osmolality of preterm breast milk. Indian Pediatr. 2004;41:63–7.

Kreins N, Buffin R, Michel-Molnar D, et al. Individualized fortification influences the osmolality of human milk. Front Pediatr. 2018;6:322.

Kreissl A, Zwiauer V, Repa A, et al. Effect of fortifiers and additional protein on the osmolarity of human milk: is it still safe for the premature infant? J Pediatr Gastroenterol Nutr. 2013;57:432–7.

Sauret A, Andro-Garcon MC, Chauvel J, et al. Osmolality of a fortified human preterm milk: the effect of fortifier dosage, gestational age, lactation stage, and hospital practices. Arch Pediatr. 2018;25:411–5.

Choi A, Fusch G, Rochow N, et al. Target fortification of breast milk: predicting the final osmolality of the feeds. PLoS One. 2016;11:e0148941.

Srinivasan L, Bokiniec R, King C, et al. Increased osmolality of breast milk with therapeutic additives. Arch Dis Child Fetal Neonatal Ed. 2004;89:F514–7.

Sievers E, Santer R, Oldigs H-D, et al. Gastrointestinal passage time in preterm infants. Monatsschr Kinderheilkd. 1995;143(SuppL 2):S76–80.

Picaud JC, Rigo J, Normand S, et al. Nutritional efficacy of preterm formula with a partially hydrolyzed protein source: a randomized pilot study. J Pediatr Gastroenterol Nutr. 2001;32:555–61.

Mihatsch WA, Hogel J, Pohlandt F. Hydrolysed protein accelerates the gastrointestinal transport of formula in preterm infants. Acta Paediatr. 2001;90:196–8.

Mihatsch WA, Franz AR, Hogel J, et al. Hydrolyzed protein accelerates feeding advancement in very low birth weight infants. Pediatrics. 2002;110:1199–203.

Cooke R, Embleton N, Rigo J, et al. High protein pre-term infant formula: effect on nutrient balance, metabolic status and growth. Pediatr Res. 2006;59:265–70.

Florendo KN, Bellflower B, van Zwol A, et al. Growth in preterm infants fed either a partially hydrolyzed whey or an intact casein/whey preterm infant formula. J Perinatol. 2009;29:106–11.

He W, Pan JH. [Clinical effect of extensively hydrolyzed formula in preterm infants: an analysis of 327 cases]. Zhongguo Dang Dai Er Ke Za Zhi. 2017;19:856–60.

Yu MX, Zhuang SQ, Wang DH, et al. [Effects of extensively hydrolyzed protein formula on feeding and growth in preterm infants: a multicenter controlled clinical study]. Zhongguo Dang Dai Er Ke Za Zhi. 2014;16:684–90.

Li XM, Jiang J, Wu Y, et al. [Effect of different feeding initiation formulas on very low birth weight infants]. Zhongguo Dang Dai Er Ke Za Zhi. 2019;21:777–82.

Ng DHC, Klassen JR, Embleton ND, et al. Protein hydrolysate versus standard formula for preterm infants. Cochrane Database Syst Rev. 2019;7:CD012412.

Uribarri J, del Castillo MD, de la Maza MP, et al. Dietary advanced glycation end products and their role in health and disease. Adv Nutr. 2015;6:461–73.

Caudill MA, Strupp BJ, Muscalu L, et al. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study. FASEB J. 2018;32:2172–80.

Bernhard W, Lange R, Graepler-Mainka U, et al. Choline supplementation in cystic fibrosis-the metabolic and clinical impact. Nutrients. 2019;11.

Andrew MJ, Parr JR, Montague-Johnson C, et al. Nutritional intervention and neurodevelopmental outcome in infants with suspected cerebral palsy: the Dolphin infant double-blind randomized controlled trial. Dev Med Child Neurol. 2018;60:906–13.

Brown JV, Embleton ND, Harding JE, et al. Multi-nutrient fortification of human milk for preterm infants. Cochrane Database Syst Rev. 2016:CD000343.

Alyahya W, Simpson J, Garcia AL, Mactier H, Edwards CA, et al. Early versus delayed fortification of human milk in preterm infants: a systematic review. Neonatology. 2020;117:24–32.

Rochow N, Fusch G, Zapanta B, et al. Target fortification of breast milk: how often should milk analysis be done? Nutrients. 2015;7:2297–310.

Morlacchi L, Mallardi D, Gianni ML, et al. Is targeted fortification of human breast milk an optimal nutrition strategy for preterm infants? An interventional study. J Transl Med. 2016;14:195.

Arslanoglu S, Boquien CY, King C, et al. Fortification of human milk for preterm infants: update and recommendations of the European Milk Bank Association (EMBA) working group on human milk fortification. Front Pediatr. 2019;7:76.

Fabrizio V, Trzaski JM, Brownell EA, et al. Individualized versus standard diet fortification for growth and development in preterm infants receiving human milk. Cochrane Database Syst Rev. 2020;11:CD013465.