Preterm infant growth and neonatal lung development
Preterm infants with BPD have slower growth compared with infants without BPD. This may relate to difficulties with nutrient delivery or with medical therapies, such as the use of steroids or diuretics. Nutrient delivery in and of itself is associated with improved pulmonary outcomes.(Wadhawan et al. 2007; Wemhoner et al. 2011) Previous studies have shown that higher energy and caloric intakes in the first postnatal weeks and avoidance of fluid overload are associated with decreased risk of BPD in very preterm infants.(Klevebro et al. 2019; Oh et al. 2005) Additionally, slower weight gain trajectories through 36-weeks corrected gestational age have been associated with an increased incidence of the diagnosis of BPD.(Ehrenkranz et al. 2011; Malikiwi et al. 2019)
Behnke et al found that more rapid feeding advancements (20-30 mL/kg/day versus 10-15 mL/kg/day) were associated with improved growth parameters at 36 weeks corrected gestational age, including among infants born small-for-gestational age. These results differ from randomized trials of fast versus slow feeding advancement which have not found more rapid feeding advancement to be associated with improved growth parameters.(Oddie et al. 2021) While infant growth was not the primary outcome of these studies, inconsistencies in findings related to growth may relate to the timing of the feeding intervention.