Enteral and Parenteral Lipid Requirements of Preterm Infants
Abstract
Lipids provide infants with most of their energy needs. The major portion of the fat in human milk is found in the form of triglycerides, the phospholipids and cholesterol contributing for only a small proportion of the total fat. Long-chain polyunsaturated fatty acids (LC-PUFAs) are crucial for normal development of the central nervous system and have potential for long-lasting effects that extend beyond the period of dietary insufficiency. Given the limited and highly variable formation of docosahexaenoic acid (DHA) from α-linolenic acid, and because DHA is critical for normal retinal and brain development in the human, DHA should be considered to be conditionally essential during early development. In early enteral studies, the amount of LC-PUFAs administered in formula was chosen to produce the same concentration of arachidonic acid and DHA as in term breast milk. Recent studies report outcome data in preterm infants fed formula with DHA content 2-3 times higher than the current concentration. Overall, these studies show that providing larger amounts of DHA supplements is associated with better neurological outcomes and may provide other health benefits. One study further suggests that the smallest babies are the most vulnerable to DHA deficiency and likely to reap the greatest benefit from high-dose DHA supplementation. Current nutritional management may not provide sufficient amounts of preformed DHA during the parenteral and enteral nutrition periods and in very preterm/very low birth weight infants until due date and higher amounts than those routinely used are likely to be necessary to compensate for intestinal malabsorption, DHA oxidation, and early deficit. Recommendations for the healthcare provider are made in order to prevent lipid and more specifically LC-PUFA deficit. Research should be continued to fill the gaps in knowledge and to further refine the adequate intake for each group of preterm infants.
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A recent overview of the lipid requirements of preterm infants emphasizes the importance of an adequate dietary intake of n-3 LCPUFA to support normal development of preterm infants.
“A recent overview of the lipid requirements of preterm infants emphasizes the importance of an adequate dietary intake of n-3 LCPUFA to support normal development of preterm infants [6].”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [6]
Lapillonne highlighted that current nutritional management guidelines may not be suitable for recommending sufficient amounts of preformed DHA.
“Lapillonne [6] highlighted that current nutritional management guidelines may not be suitable for recommending sufficient amounts of preformed DHA.”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [6]
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Herrera, E., & Ortega, H. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-35214-7.00036-6
Ng, D. V. Y. (2015) · TSpace (University of Toronto)
Post-Marketing Quality Control of Preterm Infant Formulas Commercialized in Abidjan, Côte d'Ivoire
Kpaibé, A. P. S. (2017) · International Journal of Nutrition and Food Sciences · doi:10.11648/j.ijnfs.20170606.16
Guo, C., Yu, M., Deng, L.-X., Liu, W.-K., & Zhuang, S. (2018) · Iranian Journal of Pediatrics · doi:10.5812/ijp.62520
SAFETY AND QUALITY OF INTRAVENOUS LIPIDS FOR NEWBORNS: CURRENT KNOWLEDGE AND FUTURE PROSPECTS
Анікін, І. О., & Snisar, V. I. (2021) · Neonatology surgery and perinatal medicine · doi:10.24061/2413-4260.xi.2.40.2021.7
Role of lipids in nutrition of premature babies with bronchopulmonary dysplasia
Александровна, Б. М., Skvortsova, V. A., Александровна, Х. Н., Illarionova, M. S., & Леонидовна, П.-С. Е. (2023) · Russian Pediatric Journal · doi:10.46563/1560-9561-2023-26-6-450-454
(2025) · American Academy of PediatricsItasca, IL eBooks · doi:10.1542/9781610027700-ch16
- Authors
- Lapillonne, A.
- Affiliations
- Hôpital Necker-Enfants Malades (FR)
- Corresponding author
- Lapillonne, Alexandre
- Venue
- World Review of Nutrition and Dietetics
- Publisher
- S. Karger AG
- Published
- 2014
- Volume
- 110
- Pages
- 82-98
- ISSN
- 0084-2230 (ISSN-L)
- 1662-3975
- OpenAlex
- W1532059518
- Cited by
- 38
- References
- 59
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 5 · 2017: 6 · 2016: 5 · 2015: 5
- FWCI
- 16.96
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- World review of nutrition and dietetics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- preterm infants, lipid requirements, long-chain polyunsaturated fatty acids, docosahexaenoic acid, DHA supplementation, enteral nutrition, parenteral nutrition, very low birth weight infants, neurological outcome, DHA deficiency, arachidonic acid, human milk fat, malabsorption
- MeSH terms
- Cholesterol, Dietary, Docosahexaenoic Acids, Enteral Nutrition, Fatty Acids, Fatty Acids, Unsaturated, Humans, Infant, Infant Nutritional Physiological Phenomena, Infant, Premature, Milk, Human, Nutritional Requirements, Parenteral Nutrition, Time Factors, Triglycerides, Arachidonic Acid, alpha-Linolenic Acid, Micronutrients, Dietary Supplements, Infant Formula
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