Assessment of growth status and nutritional management of prematurely born infants after hospital discharge: A position paper of the ESPGHAN Nutrition Committee
Year: 2025
Type: article
Abstract: OBJECTIVES: The aim of the manuscript is to provide evidence-based or expert consensus-based recommendations for growth assessment and nutritional management of preterm-born infants during the post-discharge period. METHODS: The search was conducted in Pubmed, MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews using the MESH terms: infant, preterm infant, low birth weight, infant food, nutritional status, nutrients, breast feeding, infant formula, human milk, dietary supplements, vitamins, iron, vitamin D, minerals, energy intake, weaning, and baby led. Overall, 402 papers were identified and screened, from which 101 publications were included in the present position paper. In the absence of evidence, recommendations reflect the authors' combined expert opinion. Final consensus was obtained through multiple e-mail exchanges and meetings with the Committee of Nutrition of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition. RESULTS: Continuous growth monitoring through measurements of weight, length, and HC post-discharge is recommended to identify growth faltering (GF) or undernutrition. To prevent disproportionate growth, weight-for-length z-scores should be included in the assessment when term equivalent age is reached. Infants discharged with a significant drop in weight and length, exceeding a -2 standard deviation loss, require tailored nutritional support to address long-term growth challenges and to support recovery to normal growth rates. Breastfeeding is highly recommended for all infants when feasible. Infants needing to catch up in growth should be given supplements, such as HMF For those fed with formula, an adequate protein: energy ratio, minerals, and trace elements should be supplied to facilitate catch-up growth. The start of solid foods should coincide with the infant's neurological developmental milestones, rather than adhering strictly to a set age. Vitamin D and iron supplementation (with regular ferritin monitoring) is recommended through at least 12 months CA. CONCLUSION: For preterm infants, close monitoring of growth after discharge and nutritional assessment is essential to identify those at high risk for GF or undernutrition and to provide individualized nutritional support when needed. These patients should either be referred to a specialized center for pediatric nutritional care or, alternatively, their general pediatrician should receive appropriate training on the subject.
DOI: 10.1002/jpn3.70054
Institutions: Kepler Universitätsklinikum, Institut de Recerca Biomèdica Catalunya Sud, Universitat Rovira i Virgili, Umeå University, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Foundation Trust, Tampere University, University of Oslo, Helsinki University Hospital, Helsinki Children's Hospital, Tampere University Hospital, Erasmus MC - Sophia Children’s Hospital, Oslo University Hospital, University of Milan, Ospedale dei Bambini Vittore Buzzi, Hospital La Paz Institute for Health Research, Universidad Autónoma de Madrid, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Ospedale Regina Margherita, University Hospital in Motol
Language: English
Topic: Infant Nutrition and Health
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4410214933