Impact of Energy and Protein Intake on Growth Outcomes in Premature Infants—A Comparison Between a South African and Dutch Cohort

(1) Background: Preterm infants are deprived of crucial growth and development that occurs during the last trimester of pregnancy. Optimal nutrition after birth, including sufficient intakes of protein and energy, have been emphasized to improve postnatal growth and development of preterm infants. This study investigated the impact of routine nutritional strategies as used in a Neonatal Intensive Care Unit in South Africa and in the Netherlands, respectively, on the preterm infant’s postnatal growth; (2) Methods: This retrospective observational study included 100 preterm infants from a South African cohort and 86 preterm infants from a Dutch cohort. Over the first four postnatal weeks, total intravenous (IV) fluid volume (i.e., IV. glucose and/or parenteral nutrition (PN) and enteral nutrition (EN) were recorded, and total energy and protein intakes were calculated. Anthropometric measurements were taken and expressed as Z-scores per week; (3) Results: At birth, the South African cohort had a higher gestational age compared to the Dutch cohort; however, weight, length and head circumference Z-scores were lower. During the first four postnatal weeks, the Dutch cohort had a significant higher total energy and protein intakes by the combination of PN and EN than the South African cohort, that mostly received EN only. In addition, the South African cohort showed a more pronounced decline in Z-scores compared to the Dutch cohort; (4) Discussion: Over the 4-week study period, the South African cohort showed more pronounced growth faltering compared to the Dutch cohort preceded by lower total energy and protein intakes; (5) Conclusions: The use of PN, while EN is incremented daily, should be considered in the South African cohort to diminish postnatal growth faltering in preterm infants.