Perinatal Growth and Nutrition

Humans, like all mammals, have an inborn desire to nurture and suckle their young
and the act of feeding is important for the bonding between mother and child. The birth
of a critically ill preterm infant disrupts this, but for a mother, the use of her milk to
feed her infant may be the most tangible role she has in the medical care of her critically sick child. Parents and caregivers see growth and feeding as important milestones
first demonstrating increasing stability, then signaling the start of recovery, and
finally showing readiness for discharge home.
Despite our intuitive and emotional connection with growth, preterm infants grow
poorly after birth and very commonly develop ex utero growth restriction (EUGR)
or postnatal growth failure. There are many reasons for this including the associated medical conditions of prematurity, but inadequate nutrient intake plays a large
part. This results both from technical difficulties in providing adequate nutrition,
and from fears about the complications associated with doing so, including metabolic derangements such as hyperglycemia and hyperlipidemia, and diseases such as
necrotizing enterocolitis.