Nutrition Interventions for Children with Special Health Care Needs

Chapter 15 - Nutrition Interventions for Premature Infant After Discharge
Preterm infants often demonstrate adequate weight gain when consuming 110-
130 kcal/kg/day. The VLBW and ELBW infants often need higher energy intakes to
support appropriate weight gain. Factors that alter energy needs, absorption, or
utilization in infants will also impact the energy requirements of preterm infants.
Preterm infant formula and human milk fortifiers are designed to meet the increased
vitamin and mineral needs of the preterm infant taking smaller volumes than the
term infant consumes. Continuation of the preterm infant formula and human milk
fortifiers in infants who weigh more than 2.5-3.0 kg will result in increased intakes
of several vitamins, including vitamins A and D. Case reports of hypervitaminosis D
suggest that these products should be discontinued when the infant is exceeding the
recommend intakes for fat-soluble vitamins.
Preterm infants are at risk for iron deficiency anemia. Preterm infants require 2-4
mg iron/kg/day by 2 months of age. This may be provided as an iron supplement or
with the appropriate volume of iron-fortified formula. In general, this iron should be
continued until 12 months of age (CA) (13).
The remainder of this chapter presents guidelines for nutrition assessment,
intervention, and evaluation/outcome after discharge from the hospital for children
who are born prematurely. Additional references and resources are included at the
end of this chapter.
170 Nutrition Interventions for Children With Special Health Care Needs