Effect of mono-component protein fortification on growth in preterm infants discharged from NICU: A three months observational study

Background: Preterm infants are at high risk of post-discharge growth faltering due to suboptimal nutrient intake. Protein fortification may support growth in this vulnerable population. Objective: To assess the effect of a mono-component protein fortifier (NEO-PF) on weight gain and feed tolerance in preterm infants following NICU discharge. Methods: This was a prospective observational study, with 52 preterm infants discharged from Neonatal Intensive Care Unit (NICU). Each infant received 1 sachet (0.75 g protein) of NEO-PF twice daily, mixed with 25 ml Expressed Breast Milk (EBM) Infants received NEO-PF (0.75 g amino acids per sachet) twice daily, mixed with 25 ml of Expressed Breast Milk (EBM) for first four weeks after discharge, followed by once daily for the next two months. Infants were followed up weekly for the first four weeks and on monthly basis for the next two months with assessment of weight gain, linear growth using standardized digital infant scales and monitored for feed tolerance and caregiver compliance. Parents were provided with the feedback form which captured the compliance and feed intolerance events observed by them and reported at every visit. Growth and feed tolerance were monitored weekly. Results: A total 52 preterm infants were included for the study with mean Gestational Age (GA) was 29.64 ± 3.1weeks, mean birth weight was 1321.81 ± 255.9. Mean weight at discharge from NICU was 1723.11 ± 13.8 and at 12 weeks was 4118.23 ± 10.6, mean length gain at discharge was 42 ± 3.21 cms and at 12 weeks was 53.47 ± 2.34 cms. There were no episodes of feed intolerance or necrotising enterocolitis episodes and none of neonates discontinued protein fortification till end of study. Parental compliance was reported to be good mainly due to ease of use and observed weight gain. Conclusion: Mono-component protein fortification with NEO-PF is effective and well-tolerated, resulting in enhanced weight gain in preterm infants post-discharge.