Feeding in Low Birth Weight LBW Newborns:Dietary Requirements

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FEEDING IN THE LOW BIRTH WEIGHT

Dr Swati Joshi,
Lecturer (Endocrinology and Epilepsy)
B J Wadia Hospital for Children,
Mumbai.

Q3) What are the dietary requirements of the various nutrients?
A3) The following table gives the recommendations of THE EUROPEAN SOCIETY OF PAEDIATRIC GASTROENTEROLOGY & NUTRITION (ESPGAN, 1987).

Similar recommendations have also been given by the Nutrition Committee of American Academy of Pediatrics & Canadian Pediatric Society.

NUTRIENT REQUIREMENTS [ ESPGAN, 1987]

NUTRIENT	REQUIREMENT	REMARKS
ENERGY	110-165 kcal/kg/day (= 130 kcal/ kg/day) by 200 ml/kg/day of EBM >165 a fat accretion <110 a Inadequate	Energy density of 65 kcal/dl (65-85 -Range)
WATER	150 -200ml / kg/day Increased in VLBW / ELBW or in conditions of insensible water losses.	Lower intakes in height failures
PROTEIN	2.9-4.0 gm/kg/day 2.2-3.1 gm protein/100Kcal	* Whey predominant proteins * Taurine content (4mg%) * Amino Acid content similar to breast milk
FAT	4.5 - 9gm /kg/day 3.6 - 7gm / 100 kcal	* MCT - 40% of fats * Linoleic acid - 4% of calories * EFA -for myelinization & growth
CARBOHYDRATES	6-10g / 100ml	Preterm formula - 50% Lactose
VITAMIN A	200mcg - 1000mcg/day	Human milk + supplemental Vitamin A
VITAMIN D	20 - 40 mcg /day	Human milk + supplemental Vitamin D
VITAMIN E	0.6 mg/100 kcal	Human milk - adequate amount. No need of supplement
VITAMIN K	Formula - 4mcg /100 kcal	Breast milk + supplement 2-3 mcg / kg Vitamin K
VITAMIN B₁	Formula - 20mcg / 100 kcal	Breast Feeds. No supplementation required.
VITAMIN B₂	Formula - 60mcg / 100kcal	Breast Feeds. No supplementation required.
VITAMIN B₃	Formula - 800mcg / 100kcal	Breast Feeds. No supplementation required.
VITAMIN B₆	Formula - 35mcg / 100kcal	Breast milk + supplement 35 mcg / 100Kcal
BIOTIN	Formula - 1.5mcg / 100kcal	Breast Feeds. No supplementation required.
FOLIC ACID	Formula - 60mcg / 100kcal	Breast milk + supplement 65 mcg / day
VITAMIN B₁₂	Formula - 0.15mcg / 100kcal	No supplementation
VITAMIN C	Formula - 7mg / 100kcal	Supplementation- 20mg/day
Calcium	70-140mg /100kcal	Ca : P ratio of 2:1
Phosphorus	50-70mg/100kcal	Breast Feeds + Supplement with 9mg/dl
Magnesium	12mg/100kcal	Breast Feeds
Iron	1.5mg/100kcal	Breast Feeds + 2 mg/kg/day

Next : Feeding in Low Birth Weight (lbw) Newborns(Contd.)

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