Original Project Justification
There is substantial evidence in the scientific literature that “[preemies] are at increased risk for developing trace mineral deficiencies… because accretion of trace minerals takes place during the last trimester of pregnancy1.” As early as 30 years ago, researchers found that “[p]reterm infants grew better when formula, human milk, or banked human milk was supplemented with protein and minerals”2. Yet, “achieving appropriate growth and nutrient accretion is often difficult because of the special needs of the preterm infant as a result of metabolic and gastrointestinal immaturity, compromised immune function, and other complicating medical conditions”3,4.
R. J. Shanler found in a 2005 study that “[i]nfants who cannot sustain adequate growth or achieve appropriate ad libitum milk intake, and those whose biochemical measurements are abnormal, will need additional nutrient supplementation. This should be in the form of a multinutrient supplement, such as they would receive in the enriched formula. Single-nutrient supplements will not meet the global needs of these infants. Enriched formula should be fed until the infant’s growth and biochemical measurements of nutritional status are normal, but the enriched formula should be used for at least 6 months post-discharge5.”
The results of a study by O’Conner, et al., in 2007 suggest that “adding a multinutrient fortifier to approximately one half of the milk provided to predominantly human milk–fed infants for 12 weeks after hospital discharge may be an effective strategy in addressing early discharge nutrient deficits and poor growth”6.
And indeed, the CDC found that “[a]dvances in the care of preterm infants, including improvements in delivery of appropriate nutrition, have reduced mortality rates for infants born weighing less than 2500 g from 9.6% to 6.2% between 1983 and 1997”7.
Yet despite the existence of a growing body of scientific evidence on the importance of enhanced nutrition for pre-term neonates, trace-mineral supplementation of LBW infants’ diets post discharge has not yet become standard practice amongst pediatricians both in the U.S. and elsewhere. It is the purpose of the Preemie Growth Project to provide a large enough demonstration of the efficacy of trace-mineral supplementation that it will both spur further scientific investigation (e.g., thru controlled, double-blind research studies), and make a compelling case for trace-mineral supplementation to become standard pediatric practice.
1Guandalini, S., ed. (2004) Textbook of Pediatric Gastroenterology and Nutrition. Taylor and Francis, London.
3Georgieff, M. K. (1999) Chapter 23. Nutrition. In: Neonatology: Pathophysiology and Management of the Newborn. 5th ed. (Avery, G. B., Fletcher, M. A. & MacDonald, M. G., eds.). Lippincott, Williams & Wilkins, Philadelphia, PA.
6O’Conner, D. L., et al. (2007) Growth and nutrient intakes of human milk-fed preterm infants provided with extra energy and nutrients after hospital discharge. Pediatrics, Vol. 121 No. 4, pp. 766-776.
7U.S.Department of Health and Human Services. Centers for Disease Control and Prevention. National Center for Health Statistics, 2000.