Abstract
Nutritional support is essential in the critical care of the very
preterm infant, however, study of the potential role of nutrition in the
multifactorial pathogenesis of bronchopulmonary dysplasia (BPD) is
limited. Achievement of full enteral feeding faster has not been shown
to be harmful and may be of benefit in extremely preterm infants. This
commentary discusses the studied risk and potential benefits of more
rapid enteral feeding advancement in extremely preterm infants.
Attention to nutritional support is essential in the critical care of
the very preterm infant. Both individual nutritional exposures and
overall infant growth relate to infant health and neurodevelopmental
outcomes. Study of the potential role of nutrition in the multifactorial
pathogenesis of bronchopulmonary dysplasia (BPD) is limited. A potential
causal pathway is apparent as nutrition is required for both growth and
repair of the preterm infant lung which is halted at the saccular stage
of development. Observational studies have shown that infants with BPD
have suboptimal growth outcomes compared with preterm infants without
lung disease, both during the neonatal hospitalization and
beyond.(Davidson et al. 1990; Huysman et al. 2003; Vohr et al. 1982;
Wang et al. 2010) The directionality of these associations is not clear.
The study “Compatibility of rapid enteral feeding advances and
noninvasive ventilation in preterm infants – an observational study”
by Behnke et al focuses on early enteral feeding and its relation to
respiratory management in extremely low birthweight infants. The study
offers insight into the safety of faster feeding advancement,
specifically with the goal to avoid mechanical ventilation by promoting
the use of non-invasive ventilation in extremely preterm infants.