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.