Growth and nutrition in late and moderate preterm infants

This thesis focusses on growth and feeding practices of late and moderate preterm infants, It reviews the factors that impact breastfeeding, provides data on their growth and body composition in infancy and their association with the type of milk, and assesses the growth adequacy using a concept formula containing large lipid droplets.
Our literature review found that maternal lower socio-economic background, education and single parenthood were associated with lower breastfeeding rates. Interventions including parental education and support in hospital or Kangaroo Care were associated with higher rates of breastfeeding initiation or breastfeeding at 6 months and longer duration respectively. A cohort study demonstrated that between term equivalent age and 3 months corrected age, infants who were breastfeeding at enrolment had a significant gain in weight-for-age z-score compared to formula-fed, and in lean mass parameters compared to formula fed, or with both formula and mixed-fed infants. Finally, we could not demonstrate non-inferiority of weight gain between randomization and 3 months corrected age between infants fed with the concept infant formula compared with a conventional term infant formula.
This thesis demonstrates advantages of breastmilk compared to formula in body composition in early infancy in late and moderate preterm infants. It highlights the knowledge on barriers and facilitators on breastfeeding for this population, which can be used in designing of breastfeeding policies. Lastly, the exploratory results of the randomized controlled trial offer reassurance around safety and experience, to conduct larger trials assessing formulas with different composition for infants who cannot have breastmilk.