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.