Growth of very low birth weight infants after increased amino acid and protein administration

To assess the impact of a high enteral protein nutrition strategy in human milk-fed very low birth weight (VLBW) infants (<1500 g) on growth during the first 5 weeks of life.Weight, length and head circumference of VLBW infants were recorded after introduction of a high protein strategy.Forty-three infants (median/interquartile range) of gestational age 27+6 weeks (26+0/29+6), birth weight 984 g (675/1130) were included. Parenteral nutrition was administered for 16 (14/18) days and the nutritional intakes achieved target values 4.3 g/kg/day protein (4.0/4.4); 128 kcal/kg/day energy (119/131). Human milk was fortified with 0.5-2.3 g/kg/day protein powder in addition to a fortifier. Near-intrauterine growth was observed: Weight gain from days 8-35: 17.6 g/kg/day (14.9/20.5); head growth from day 1-35: 0.70 cm/week (0.50/0.80); length growth from day 1-35: 1.0 cm/week (0.8/1.2). The total protein intake was shown to have a significant impact on infant's weight gain up to the 35th day of life.High protein nutrition enables similar to fetal growth weight gain and head growth of VLBW infants during the first 5 weeks of life. These data support recently published ESPGHAN recommendations.