This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Nationally, nutritional strategies for very preterm infants are resulting in postnatal growth failure from which the neonate does not recover by hospital discharge. Undernutrition, particularly insufficient protein intake during critical development periods adversely affects long-term neurodevelopmental and health outcomes. Optimizing nutritional support is critical to avoid these adverse outcomes. The only published recommendation for providing comprehensive nutrition to the preterm neonate through the time of discharge is the American Academy of Pediatrics (AAP) recommendation to mimic the growth rate of the normal fetus of the same gestational age as the preterm infant. There are no guidelines by the AAP as to how this should be achieved, and no data in the literature to support or refute this recommendation. We believe that it is critical to determine if this is a valid recommendation. This study aims to determine if nutrient delivery rates that are: a) started immediately after birth in preterm neonates and maintained through 36 weeks postconceptional age, and b) administered in quantities that duplicate what is delivered to the fetus of the same gestational age, will achieve the AAP recommendation that extrauterine growth should approximate that of the fetus at the same gestational age.
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