The New England Journal of MedicineNutritional Support for Moderate-to-Late–Preterm Infants — A Randomized Trial

Evaluating Nutritional Strategies for Preterm Infants

In a comprehensive investigation into the effectiveness of various nutritional interventions for moderate-to-late preterm infants, a new multicenter, factorial, randomized trial provides valuable insights. This study meticulously assesses the impact of different feeding strategies on infant development, offering data-driven guidance to enhance neonatal care practices.

Study Design:

• Participants: The trial included 532 infants born between 32 weeks 0 days and 35 weeks 6 days of gestation, with a nearly even gender distribution (55% male).
• Interventions: Infants were randomly assigned to receive either intravenous amino acids or dextrose solution until full milk feeding was established; a milk supplement or exclusive mother’s breast milk when maternal milk was insufficient; and either exposure to taste and smell prior to gastric-tube feeding or no sensory exposure.
• Objective: The primary goals were to measure body-fat percentage at 4 months of corrected gestational age and to record the time until full enteral feeding was achieved.

Key Findings:

• Body Composition: No significant differences were found in body-fat percentage at 4 months between infants receiving parenteral nutrition versus those receiving dextrose solution, or between those receiving milk supplements versus exclusive breast milk.
• Enteral Feeding Time: The introduction of taste and smell did not significantly reduce the time to achieve full enteral feeding.
• Adverse Events: Only one serious adverse event was reported, highlighting the general safety of the interventions.

HCN Medical Memo
Although the trial did not identify a superior nutritional intervention for moderate-to-late preterm infants, it reinforces the safety and adequacy of existing feeding practices. These findings suggest that standard nutritional support is appropriate for this population, providing a solid foundation for ongoing research and optimization of preterm infant care.

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