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Collections under which this article appears: Guidelines Neonatal Breastfeeding and infant nutrition Perinatal

Archives of Disease in Childhood Fetal and Neonatal Edition 2003;88:F302
© 2003 Archives of Disease in Childhood Fetal and Neonatal Edition
 

Weaning preterm infants: a randomised controlled trial

L D Marriott¹, K D Foote², J A Bishop¹, A C Kimber³ and J B Morgan¹

¹ School of Biomedical and Life Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK
² Department Paediatrics and Child Health, Royal Hampshire County Hospital, Winchester, Hampshire SO22 5DG, UK
³ School of Applied Statistics, University of Reading, PO Box 240, Reading, Berkshire RG6 6FN, UK

Correspondence to:
Dr Marriott, Medical Research Council Environmental Epidemiology Unit, Tremona Rd, Southampton SO16 6YD, UK;
ldm@mrc.soton.ac.uk

Objective: To assess the effect on growth and iron status in preterm infants of a specially devised weaning strategy compared with current best practices in infant feeding. The preterm weaning strategy recommended the early onset of weaning and the use of foods with a higher energy and protein content than standard milk formula, and foods that are rich sources of iron and zinc.

Subjects and design: In a blinded, controlled study, 68 preterm infants (mean (SD) birth weight 1470 (430) g and mean (SD) gestational age 31.3 (2.9) weeks) were randomised to either the preterm weaning strategy group (n = 37) or a current best practice control group (n = 31), from hospital discharge until 1 year gestation corrected age (GCA).

Main outcome measures: Weight, supine length, occipitofrontal head circumference, and intakes of energy, protein, and minerals were determined at 0, 6, and 12 months GCA. Levels of haemoglobin, serum iron, and serum ferritin were assayed at 0 and 6 months GCA.

Results: Significant positive effects of treatment included: greater increase in standard deviation length scores and length growth velocity; increased intake of energy, protein, and carbohydrate at 6 months GCA and iron at 12 months GCA; increased haemoglobin and serum iron levels at 6 months GCA.

Conclusions: The preterm weaning strategy significantly influenced dietary intakes with consequent beneficial effects on growth in length and iron status. This strategy should be adopted as the basis of feeding guidelines for preterm infants after hospital discharge.

Keywords: weaning; preterm; growth; iron

Abbreviations: PWS, preterm weaning strategy; GCA, gestation corrected age; SDS, standard deviation score

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Preterm weaning strategy-is it beneficial in the longer term?

Mansoor Ahmed

ADC Online, 8 Jul 2003 [Response]