Anemia of Prematurity - Portal Neonatal

growth and bone mineral content has been documented; however, evidence of long-term
benefit is insufficient. At present, whether breast milk feeding (with or without fortification)
improves long-term neurodevelopment compared to preterm formula is controversial.
• Supplementation: Supplementation with long-chain polyunsaturated fatty acids (LCPUFAs),
such as docosahexaenoic acid (DHA) and arachidonic acid (AA), has been recommended
for preterm infants on physiologic grounds. Although visual maturation may possibly be
somewhat accelerated, no long-term benefits have been demonstrated yet.
• Feedings at discharge: At discharge, premature infants usually are fed either breast milk or
formula (22 cal/oz or 20 cal/oz). Some evidence exists that 22-cal/oz formula may lead to
slightly better nutritional outcomes, probably because of its higher energy, calcium, and
phosphate content.
PICTURES Section 10 of 11
Picture 1. Fluid, electrolyte, and nutrition management of the newborn. This patient is an ill preterm
infant, a common situation requiring fluid, electrolyte, and nutrition management in a neonatal
intensive care unit.
Picture 2. Fluid, electrolyte, and nutrition management of the newborn. Radiograph depicts
necrotizing enterocolitis in a preterm infant. Note the extensive pneumatosis intestinalis and the
portal venous air. This situation often requires long-term administration of total parenteral nutrition.
BIBLIOGRAPHY Section 11 of 11
• Denne SC, Clark SE, Poindexter BB: Nutrition and metabolism in the high-risk neonate. In:
Fanaroff AA, Martin RJ, eds. Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant.
6th ed. St Louis: Mosby; 1997:562-621.
• Macdonald PD, Skeoch CH, Carse H, et al: Randomised trial of continuous nasogastric,
bolus nasogastric, and transpyloric feeding in infants of birth weight under 1400 g. Arch Dis
Child 1992 Apr; 67(4 Spec No): 429-31[Medline].
• Oh W: Fluid and electrolyte management. In: Fanaroff AA, Martin RJ, eds. Neonatal-
Perinatal Medicine: Diseases of the Fetus and Infant . 6th ed. St. Louis: Mosby; 1997:622-
38.
• Omar SA, DeCristofaro JD, Agarwal BI, La Gamma EF: Effects of prenatal steroids on water
and sodium homeostasis in extremely low birth weight neonates. Pediatrics 1999 Sep;
104(3 Pt 1): 482-8[Medline].
• Omar SA, DeCristofaro JD, Agarwal BI, La Gamma EF: Effect of prenatal steroids on