Nutrition of the Premature Neonate: Physiology, Pathology and Management of the Immature and Developing Gut

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About this Research Topic

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Background

Nutrition of preterm and very preterm neonates is a fundamental part of their management. Optimal nutrition improves growth, neurodevelopmental outcomes and may have a role on the development of prematurity related pathologies as infection/sepsis, retinopathy of prematurity (ROP) and Bronchopulmonary dysplasia (BPD).

However, optimising the nutrition of preterm neonates remains a challenge, despite the improvement of knowledge in the field, the development of new devices and solutions for parenteral nutrition, newer preterm formula, and molecules to ameliorate immunomodulation of the immature gut.

The pathogenesis of malnutrition for preterm infants is multifactorial depending on their wellbeing in utero and on their clinical course in NICU. Moreover, intrauterine growth restriction (IUGR) may lead to a malnourished preterm neonate. Subsequent complications of prematurity such as infection or feeding intolerance may worsen malnutrition or lead to extrauterine growth restriction (EUGR).

The aim of neonatologists regarding nutrition of premature neonates is to reach full enteral feeding as soon as possible to avoid complications of parenteral nutrition (that include sepsis and cholestasis). At the same time, the aim is to gain optimal growth corresponding to “in utero growth” patterns, and to treat feeding intolerance to avoid necrotizing enterocolitis. However, these aims still remain difficult to achieve.

The scope of this Research Topic is to improve knowledge for readers on aspects of nutrition in the premature neonate, with a focus on the physiology and pathology of the immature and developing gut, as well as to give updated tools for its management.

Original research and review articles will be considered on the following specific themes:
- Role of colostrum and breast milk (own mother’s milk, donor bank milk) on gut maturation and protection
- Role of molecules (e.g. lactoferrin, probiotics, immunonutrients, bioactive peptides and vitamin D) for the immunomodulation, prevention of infections and maturation of the developing gut
- Functional disorders of the immature and developing gastrointestinal tract
- Novel strategies to prevent, diagnose early and treat necrotizing enterocolitis
- Strategies to improve parenteral and enteral nutrition of preterm neonates
- IUGR, feeding intolerance and postnatal growth
- Prevention and management of EUGR
- Development of oral feeding skills and optimization of a safe transition to oral feeding in preterm infants
- Role of nutrition of preterm neonates on the development of prematurity related pathologies (e.g. ROP, BPD, osteopenia of prematurity and neurodevelopmental outcomes)

Keywords: Nutrition, Neonate, Developing Gut, Physiology, Pathology

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