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Nutrition for Preterm and Critically Ill Infants

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: closed (15 April 2023) | Viewed by 6796

Special Issue Editors

Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Interests: respiratory disease of the newborn; non-invasive ventilation; HFT; neonatal and pediatric nutrition; vaccination; neonatal and pediatric COVID-19; neonatal infections; genetic and rare neonatal diseases; congenital malformations; informed consent for minors; infectious disease transmissions; off labelel
Special Issues, Collections and Topics in MDPI journals
Department of Biomedical Science and Human Oncology, Section of Neonatology and Neonatal Intensive Care Unit, University of Bari “Aldo Moro”, 70100 Bari, Italy
Interests: preterm newborns; nutrition; microbiota; neonatal gastroenterology; gastroesophageal reflux
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nutrition for “critical” infants represents a real challenge for neonatologists and pediatricians, both in NICU settings and thereafter. One of the most significant issues is the development of the so-called “extrauterine growth retardation” of ELBW newborns. There are many unanswered questions regarding its management, newborns’ catch-up growth, and long-term effects.

Optimal nutritional management is also a significant problem in newborns with  prematurity, intrauterine growth retardation, sepsis, surgical conditions, perinatal asphyxia, etc., all of which are characterized by an “acute stress response” aimed at restoring homeostasis.

Recently, gender-based differences in neonatology, as well as in many other medical specialties, have also been studied. They represent a promising approach for research and possible clinical applications. However, use of parenteral and enteral intakes varies widely, with a range of different approaches.

This Special Issue on “Nutrition for Preterm and Critically Ill Infants” will explore the different effects of nutrition in fragile neonates and children. We welcome the original research articles and reviews (systematic reviews, critical reviews and meta-analyses) with physiopathological bases, enteral and parenteral nutrition timing and schemes, and short- and long-term clinical effects.

Prof. Dr. Nicola Laforgia
Dr. Maria Elisabetta Baldassarre
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • preterm newborns
  • neonatal sepsis
  • surgical conditions in newborns
  • perinatal asphyxia
  • IUGR
  • EUGR
  • enteral nutrition
  • parenteral nutrition
  • sex-related differences
  • permissive undernutrition

Published Papers (4 papers)

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Research

10 pages, 797 KiB  
Article
SLAB51 Multi-Strain Probiotic Formula Increases Oxygenation in Oxygen-Treated Preterm Infants
Nutrients 2023, 15(17), 3685; https://doi.org/10.3390/nu15173685 - 23 Aug 2023
Cited by 2 | Viewed by 1712
Abstract
Preterm infants are at risk of hypoxia and hyperoxia because of the immaturity of their respiratory and antioxidant systems, linked to increased morbidity and mortality. This study aimed to evaluate the efficacy of a single administration of the SLAB51 probiotic formula in improving [...] Read more.
Preterm infants are at risk of hypoxia and hyperoxia because of the immaturity of their respiratory and antioxidant systems, linked to increased morbidity and mortality. This study aimed to evaluate the efficacy of a single administration of the SLAB51 probiotic formula in improving oxygenation in respiratory distress syndrome (RDS)-affected premature babies, thus reducing their need for oxygen administration. Additionally, the capability of SLAB51 in activating the factor-erythroid 2-related factor (Nrf2) responsible for antioxidant responses was evaluated in vitro. In two groups of oxygen-treated preterm infants with similar SaO2 values, SLAB51 or a placebo was given. After two hours, the SLAB51-treated group showed a significant increase in SaO2 levels and the SaO2/FiO2 ratio, while the control group showed no changes. Significantly increased Nrf2 activation was observed in intestinal epithelial cells (IECs) exposed to SLAB51 lysates. In preterm infants, we confirmed the previously observed SLAB51’s “oxygen-sparing effect”, permitting an improvement in SaO2 levels. We also provided evidence of SLAB51’s potential to enhance antioxidant responses, thus counteracting the detrimental effects of hyperoxia. Although further studies are needed to support our data, SLAB51 represents a promising approach to managing preterm infants requiring oxygen supplementation. Full article
(This article belongs to the Special Issue Nutrition for Preterm and Critically Ill Infants)
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16 pages, 1296 KiB  
Article
Trend and Predictors of Breastmilk Feeding among Very-Low-Birth-Weight Infants in NICU and at Discharge
Nutrients 2023, 15(15), 3314; https://doi.org/10.3390/nu15153314 - 26 Jul 2023
Viewed by 1500
Abstract
Mothers’ own milk (MOM) for premature babies is considered a life-saving drug for its proven protective action against the complications of prematurity and for effects on outcome in the short and long term, especially neurological ones. We studied the use of MOM for [...] Read more.
Mothers’ own milk (MOM) for premature babies is considered a life-saving drug for its proven protective action against the complications of prematurity and for effects on outcome in the short and long term, especially neurological ones. We studied the use of MOM for infants weighing <1500 g for a period of 5 years, evaluating the trend over time and the impact of some variables on human milk feeding performance. Statistical comparisons concerned the rate of feeding with breast milk during a stay in an NICU and at discharge with respect to two types of variables: (1) maternal and neonatal characteristics (gestational age, birth weight, type of pregnancy (whether single or twin), maternal age) and (2) feeding characteristics (time of the start of minimal enteral feeding and availability of MOM, days until the achievement of full enteral feeding). Group comparisons were performed using ANOVA or t-test for continuous variables and Pearson chi-squared test or Fisher exact test for categorical variables. We observed an increase, between 2017 and 2021, in MOM use (p = 0.003). The availability of the own mothers’ milk occurred, on average, on the fourth day of life and improved over the years. The start of minimal enteral feeding (MEF) with human milk averaged 1.78 days, and 54.3% of VLBWs received MEF with donor milk on the first day of life. The average percentage of feeding with the mothers’ milk at discharge was 47.6%, with 36.1% of exclusive MOM and an increase from 45.8% in 2017 (33.3% exclusive) to 58.82% (41.18% exclusive) in 2021. The mean average daily growth of the weight improved (p < 0.001) during this period, and there was no statistical difference between infants fed with maternal milk and those fed with bank milk. Older maternal age, early-start feeding with maternal milk and low gestational age had a statistically significant impact on feeding with MOM at discharge. Full article
(This article belongs to the Special Issue Nutrition for Preterm and Critically Ill Infants)
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11 pages, 795 KiB  
Article
Neonatal Leptin Levels Predict the Early Childhood Developmental Assessment Scores of Preterm Infants
Nutrients 2023, 15(8), 1967; https://doi.org/10.3390/nu15081967 - 19 Apr 2023
Cited by 4 | Viewed by 1122
Abstract
Preterm infants have low circulating levels of leptin, a key trophic hormone that influences growth and development. While the clinical importance of prematurity-associated leptin deficiency is undefined, recent preclinical and clinical investigations have shown that targeted enteral leptin supplementation can normalize neonatal leptin [...] Read more.
Preterm infants have low circulating levels of leptin, a key trophic hormone that influences growth and development. While the clinical importance of prematurity-associated leptin deficiency is undefined, recent preclinical and clinical investigations have shown that targeted enteral leptin supplementation can normalize neonatal leptin levels. We tested the hypothesis that, independent of growth velocity, prematurity-related neonatal leptin deficiency predicts adverse cardiovascular and neurodevelopmental outcomes. In a planned 2-year longitudinal follow-up of 83 preterm infants born at 22 to 32 weeks’ gestation, we obtained blood pressures from 58 children and the Ages & Stages Questionnaire (ASQ-3) for 66 children. Based on univariate analysis, blood pressures correlated with gestational age at birth (R = 0.30, p < 0.05) and weight gain since discharge (R = 0.34, p < 0.01). ASQ-3 scores were significantly higher in female than male children. Utilizing best subset regression with Mallows’ Cp as the criterion for model selection, higher systolic blood pressure was predicted by rapid postnatal weight gain, later gestation at delivery and male sex (Cp = 3.0, R = 0.48). Lower ASQ-3 was predicted by lower leptin levels at 35 weeks postmenstrual age, earlier gestation at delivery and male sex (Cp = 2.9, R = 0.45). Children that had leptin levels above 1500 pg/mL at 35 weeks postmenstrual age had the highest ASQ-3 scores at 2 years. In conclusion, independent of growth velocity, higher leptin levels at 35 weeks’ gestation are associated with better developmental assessment scores in early childhood. While longer-term follow-up of a larger cohort is needed, these findings support investigations that have suggested that targeted neonatal leptin supplementation could improve the neurodevelopmental outcomes of preterm infants. Full article
(This article belongs to the Special Issue Nutrition for Preterm and Critically Ill Infants)
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11 pages, 1570 KiB  
Article
Characteristics of Gut Microbiota in Small for Gestational Age Infants with Very Low Birth Weight
Nutrients 2022, 14(23), 5158; https://doi.org/10.3390/nu14235158 - 04 Dec 2022
Cited by 2 | Viewed by 1947
Abstract
Small for gestational age (SGA) birth is associated with high rates of mortality and morbidity in preterm infants. The aim of this preliminary observational study was to investigate the difference in gut microbiota between SGA and appropriate for gestational age (AGA) preterm infants [...] Read more.
Small for gestational age (SGA) birth is associated with high rates of mortality and morbidity in preterm infants. The aim of this preliminary observational study was to investigate the difference in gut microbiota between SGA and appropriate for gestational age (AGA) preterm infants with very low birth weight (VLBW). We included 20 VLBW preterm infants (SGA, n = 10; AGA, n = 10) in this study. Stool samples were collected on days 7, 14, and 30 after birth. We performed 16S ribosomal DNA sequencing to compare microbiota composition between both groups. The SGA group exhibited a lower abundance of Klebsiella on day 14 (SGA, 0.57%; AGA, 7.42%; p = 0.037). On day 30, the SGA group exhibited a lower abundance of Klebsiella (SGA 3.76% vs. AGA 16.05%; p = 0.07) and Enterobacter (SGA 5.09% vs. AGA 27.25%; p = 0.011) than the AGA group. Beta diversity demonstrated a separation of the bacterial community structure between both groups on day 30 (p = 0.019). The present study revealed that a distinct gut microbiota profile gradually develops in SGA preterm infants with VLBW during the early days of life. The role of changes in gut microbiota structure warrants further investigation. Full article
(This article belongs to the Special Issue Nutrition for Preterm and Critically Ill Infants)
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