Outcomes of early parenteral nutrition for premature infants

Objective: The objective of this study was to evaluate the safety and efficacy of early amino acid (early AA) administration in very low birth weight (VLBW) infants. Study Design: A pre- and post-intervention study was conducted after initiating an early AA administration protocol. Clinical outcomes were collected for all VLBW infants admitted on the first day of life for 9 months before protocol initiation (standard parenteral nutrition (PN)), and 10 months after initiation of early AA. Result: In all, 88 infants met study criteria for standard PN, and 85 infants for early AA administration. The patient characteristics were similar between the groups. There were no differences in mortality, the day birth weight was regained, the day enteral feeds started, the duration of PN, the day full feeds achieved and weight at 32 weeks post-menstrual age. No differences were found for late sepsis, direct hyperbilirubinemia and chronic lung disease. Necrotizing enterocolitis (NEC) occurred more frequently in the early AA administration group (12 vs 1%, P = 0.012). Conclusion: Early AA administration for VLBW infants was as efficacious as standard therapy, although increased NEC in the early AA period may have negatively affected growth and nutrition in that period. Journal of Perinatology (2010) 30, 403-407; doi: 10.1038/jp.2009.173; published online 29 October 2009