Cap 6 Enteral nutrition in preterm neonates

Introduction In the past decades, there has been a significant increase in the survival rate of preterm infants, especially very-low- birth-weight (VLBW, <1500 g) neonates. The nutritional problems of preterm babies have become particularly rele- vant, as numerous studies have underlined the importance of early feeding on short- and long-term development [1]. The gastrointestinal (GI) tract of preterm infants and especially of VLBW infants is immature at birth and initially incapable of receiving full enteral feeding [2]. Retard in maturation of GI motility manifests itself in so-called “neonatal feeding intol- erance” which is characterized by delayed gastric emptying, abdominal distension, and constipation. This paraphysiolog- ic condition may evolve in necrotizing enterocolitis (NEC), a major GI emergency in preterm newborn. NEC almost always occurred in infants who received enteral nutrition and who show sign of feeding intolerance. For these reasons, the introduction of feeding was frequently delayed, often for prolonged periods, increasing the risk of malnutrition.