Higher protein and energy intake is associated with increased weight gain in pre‐term infants

Aim:  To characterise and compare the nutritional management and growth in infants <33 weeks' gestation in two tertiary centres. Methods:  An audit of daily intake and growth from birth to discharge home was undertaken in two neonatal units: The KK Women's and Children's Hospital Singapore and the Adelaide Women's and Children's Hospital, South Australia. Mixed models were used to model intake and daily weight (g/day) accounting for repeated day per subject. Results:  The clinical characteristics of the two cohorts were similar. The Adelaide cohort had a higher initial energy intake in the first 5 days compared with the Singapore cohort, and a significantly greater weekly increase of 21.0 kcal/week (95% CI 7.7–34.3; P = 0.002). The Adelaide cohort also had a higher initial protein intake and a significantly greater weekly increase of 0.88 g/week (95% CI 0.5, 1.3), P < 0.001) compared with the Singapore cohort. The weight gain of the Adelaide cohort was 9 g/day more than the Singapore cohort (95% CI 7.3, 10.7; P < 0.001). Post-natal growth failure was evident in 32% (n = 64) of the Adelaide cohort and 64% (n = 94) of the Singapore cohort. Conclusions:  The two centres showed distinct differences in nutritional management. A higher energy and protein intake was associated with improved growth yet growth in both cohorts was still below current recommendations.