Optimizing individual nutrition in preterm very low birth weight infants: double-blinded randomized controlled trial

Objective In preterm neonates fed human milk, fortification may be adjusted by (1) optimization, based on growth rate and serum nutrient analyses, or (2) individualization, based on serial milk nutrient analyses. The primary aim was to determine whether individualized plus optimized nutrition (experimental) improves velocity of weight gain and linear growth from birth to endpoint (36 weeks postmenstrual age or discharge) when compared with optimized nutrition alone (controls). Study design Double-blinded parallel group randomized trial in 120 neonates <29 weeks gestational age (GA) or <35 weeks and small for GA (birth weight < 10th centile). Result Weight-gain velocity (13.1 +/- 2.1, n = 57 controls, vs. 13.0 +/- 2.6 g kg(-1) day(-1), n = 59 experimental, P = 0.87), linear growth (0.9 +/- 0.2, n = 55, vs. 0.9 +/- 0.2 cm week(-1), n = 52, P = 0.90) and frequency of weight/length disproportion (2% vs. 2%, P = 0.98) were similar in both groups. Conclusions Individualized plus optimized nutrition does not improve weight gain, linear growth, or weight/length disproportion at endpoint versus optimized nutrition alone.