After NICU Discharge: Preterm Infant Feeding and Growth Through the First Year

BackgroundLittle is known about preterm infant feeding and growth in the outpatient community setting and there are no standardized post-hospital discharge feeding guidelines. ObjectiveTo describe the post-neonatal intensive care unit (NICU) discharge growth trajectories of very preterm (<32 weeks gestational age (GA)) and moderately preterm (32-34 6/7 weeks GA) infants managed by community pediatric providers and to determine the association between post-discharge feeding type and growth Z-scores and z-score changes through 12 months corrected age (CA). MethodsVery preterm infants (n=104) and moderately preterm infants (n=109) born 2010-2014 and followed in hospital-affiliated community health clinics were enrolled in a single-center retrospective cohort study. Infant home feeding type and anthropometry were abstracted from outpatient medical chart review, and repeated measures analysis of variance calculated adjusted growth z-scores and z-score differences between 4 and 12 months CA. Linear regression models tested the relationship between type of home feeding at 4 months CA and anthropometry at 12 months CA. ResultsBy 12 months CA, 5% of very preterm and 10% of moderately preterm infants were overweight. Moderately preterm infants on nutrient-enriched vs. standard term feeds had lower length z-scores at 12 months CA (-0.04 vs. 0.37, P=.03). Feeding type at 4 months CA predicted 12 month CA body mass index z-scores for very preterm infants ({beta}=-0.66(-1.28, -0.04)). ConclusionCommunity pediatric providers may manage preterm infant post-NICU discharge feeding in the context of growth. Further research is needed to explore modifiable drivers of obesity risk in preterm infants to optimize infant development.