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Enteral nutrition in preterm infants (2022): a position paper from the ESPGHAN ommittee on Nutrition and invited experts

Enteral nutrition in preterm infants (2022): a position paper from the ESPGHAN ommittee on Nutrition and invited experts
Enteral nutrition in preterm infants (2022): a position paper from the ESPGHAN ommittee on Nutrition and invited experts
Objectives: To review the current literature and develop consensus conclusions and recommendations on nutrient intakes and nutritional practice in preterm infants with birthweight <1800 g. Methods: The European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee of Nutrition (CoN) led a process that included CoN members and invited experts. Invited experts with specific expertise were chosen to represent as broad a geographical spread as possible. A list of topics was developed, and individual leads were assigned to topics along with other members, who reviewed the current literature. A single face-To-face meeting was held in February 2020. Provisional conclusions and recommendations were developed between 2020 and 2021, and these were voted on electronically by all members of the working group between 2021 and 2022. Where >90% consensus was not achieved, online discussion meetings were held, along with further voting until agreement was reached. Results: In general, there is a lack of strong evidence for most nutrients and topics. The summary paper is supported by additional supplementary digital content that provide a fuller explanation of the literature and relevant physiology: introduction and overview; human milk reference data; intakes of water, protein, energy, lipid, carbohydrate, electrolytes, minerals, trace elements, water soluble vitamins, and fat soluble vitamins; feeding mode including mineral enteral feeding, feed advancement, management of gastric residuals, gastric tube placement and bolus or continuous feeding; growth; breastmilk buccal colostrum, donor human milk, and risks of cytomegalovirus infection; hydrolyzed protein and osmolality; supplemental bionutrients; and use of breastmilk fortifier. Conclusions: We provide updated ESPGHAN CoN consensus-based conclusions and recommendations on nutrient intakes and nutritional management for preterm infants.
enteral nutrition, neonatal intensive care unit, neonate, nutritional requirements, preterm infant, Water, Humans, Infant, Enteral Nutrition, Vitamins, Infant, Premature, Gastroenterology, Child, Infant, Newborn, Milk, Human
0277-2116
248-268
Embleton, Nicholas David
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Jennifer Moltu, Sissel
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Lapillonne, Alexandre
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Van Den Akker, Chris H.P.
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Carnielli, Virgilio
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Fusch, Christoph
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Gerasimidis, Konstantinos
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Van Goudoever, Johannes B.
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Haiden, Nadja
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Iacobelli, Silvia
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Johnson, Mark J.
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Meyer, Sascha
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Mihatsch, Walter
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De Pipaon, Miguel Saenz
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Rigo, Jacques
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Zachariassen, Gitte
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Bronsky, Jiri
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Indrio, Flavia
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Köglmeier, Jutta
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De Koning, Barbara
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Norsa, Lorenzo
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Verduci, Elvira
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Domellöf, Magnus
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et al.
Embleton, Nicholas David
5c621f1e-cee5-4efa-ac43-8a195410c11c
Jennifer Moltu, Sissel
e6aaa6f5-9541-4b97-8dde-8d862cb5c4b5
Lapillonne, Alexandre
6c993050-dd4f-4fe7-81f3-01f4f9ba48f7
Van Den Akker, Chris H.P.
38e19599-e9c0-4fc6-a34e-90c5742dec32
Carnielli, Virgilio
a3cc8c25-2a57-4663-80d2-8426b87dbfda
Fusch, Christoph
2539a0f2-01b5-42cf-9277-75d0417a1a15
Gerasimidis, Konstantinos
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Van Goudoever, Johannes B.
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Haiden, Nadja
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Iacobelli, Silvia
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Johnson, Mark J.
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Meyer, Sascha
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Mihatsch, Walter
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De Pipaon, Miguel Saenz
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Rigo, Jacques
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Zachariassen, Gitte
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Bronsky, Jiri
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Indrio, Flavia
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Köglmeier, Jutta
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De Koning, Barbara
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Norsa, Lorenzo
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Verduci, Elvira
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Domellöf, Magnus
ab4d9c8a-ee67-4341-b754-33f9136f68f6

Embleton, Nicholas David, Jennifer Moltu, Sissel, Lapillonne, Alexandre and Johnson, Mark J. , et al. (2023) Enteral nutrition in preterm infants (2022): a position paper from the ESPGHAN ommittee on Nutrition and invited experts. Journal of Pediatric Gastroenterology and Nutrition, 76 (2), 248-268. (doi:10.1097/MPG.0000000000003642).

Record type: Article

Abstract

Objectives: To review the current literature and develop consensus conclusions and recommendations on nutrient intakes and nutritional practice in preterm infants with birthweight <1800 g. Methods: The European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee of Nutrition (CoN) led a process that included CoN members and invited experts. Invited experts with specific expertise were chosen to represent as broad a geographical spread as possible. A list of topics was developed, and individual leads were assigned to topics along with other members, who reviewed the current literature. A single face-To-face meeting was held in February 2020. Provisional conclusions and recommendations were developed between 2020 and 2021, and these were voted on electronically by all members of the working group between 2021 and 2022. Where >90% consensus was not achieved, online discussion meetings were held, along with further voting until agreement was reached. Results: In general, there is a lack of strong evidence for most nutrients and topics. The summary paper is supported by additional supplementary digital content that provide a fuller explanation of the literature and relevant physiology: introduction and overview; human milk reference data; intakes of water, protein, energy, lipid, carbohydrate, electrolytes, minerals, trace elements, water soluble vitamins, and fat soluble vitamins; feeding mode including mineral enteral feeding, feed advancement, management of gastric residuals, gastric tube placement and bolus or continuous feeding; growth; breastmilk buccal colostrum, donor human milk, and risks of cytomegalovirus infection; hydrolyzed protein and osmolality; supplemental bionutrients; and use of breastmilk fortifier. Conclusions: We provide updated ESPGHAN CoN consensus-based conclusions and recommendations on nutrient intakes and nutritional management for preterm infants.

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Enteral_Nutrition_in_Preterm_Infants__2022___A.204 - Accepted Manuscript
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Accepted/In Press date: 9 October 2022
e-pub ahead of print date: 21 October 2022
Published date: 1 February 2023
Additional Information: Funding Information: N.D.E. reports receipt of research grant supports from National Institutes for Health Research (UK), Prolacta Bioscience (US), Danone Early Life Nutrition, Medical Research Council, and Action Medical Research; payment/honorarium for lectures from Nestle Nutrition Institute, Astarte Medical. S.J.M. reports receipt of research support from DSM Nutritional Products and payment/honorarium for lectures from Baxter. A.L. reports receipt of lecture fees and/or nonfinancial support from Baxter, Fresenius, Nestle, and Mead Johnson Nutrition. C.H.P.v.d.A. reports receipt of speakers and consultancy honoraria from Nestlé Nutrition Institute, Nutricia Early Life Nutrition, and Baxter. V.C. reports speaker fees from Baxter and Chiesi Pharma. C.F. reports receipt of lecture fees from Nestle Nutrition Institute, Medela, Prolacta, and Neobiomics and consultancy fees for Medela, Baxter, Hipp, and Nutricia. K.G. reports receipt of research grants, speakers and consultancy fees and hospitality from Nestle Health Sciences, Nutricia-Danone, Baxter, Mylan, Dr. Falk Pharma, Abbott, Servier, and Janssen. J.B.v.G. reports a research grant from Nutrinia and FP7/Danone. Founder & Director of Dutch National Human Milk Bank and council member of National Health Council. N.H. reports consulting fees from Medis, MAM, Baxter, and Nestle and speaker fees from Nestle, Baxter, Danone, and Hipp outside the submitted work. M.J.J. reports research grants from NeoKare UK Ltd. S.M. reports research support from Nestle Health Science. L.N. reports consultancy advice for Takaeda and Nestle. J.B. reports personal fees and nonfinancial support from AbbVie, Nutricia, and Biocodex, personal fees from MSD, Nestlé, and Ferring. F.I. reports receipt of payment/honorarium for lectures from Biogaia, Nestle, Danone, and Abbot, and consultancy fees from Biogaia. E.V. reports grant/research support from Nutricia Italia Spa, Nestle Health Science – Vitaflo Italy, FoodAR srl Italy, PIAM Pharma, and Integrative Care. M.D. reports a research grant from Prolacta and speaker fees from Semper, Baxter, Mead Johnson, and Nestlé. The remaining authors report no conflicts of interest. Publisher Copyright: © 2023 Lippincott Williams and Wilkins. All rights reserved.
Keywords: enteral nutrition, neonatal intensive care unit, neonate, nutritional requirements, preterm infant, Water, Humans, Infant, Enteral Nutrition, Vitamins, Infant, Premature, Gastroenterology, Child, Infant, Newborn, Milk, Human

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Local EPrints ID: 475322
URI: http://eprints.soton.ac.uk/id/eprint/475322
ISSN: 0277-2116
PURE UUID: 3f51f363-692a-4938-8d89-699bf52a31f6

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Date deposited: 15 Mar 2023 17:38
Last modified: 17 Mar 2024 13:17

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Contributors

Author: Nicholas David Embleton
Author: Sissel Jennifer Moltu
Author: Alexandre Lapillonne
Author: Chris H.P. Van Den Akker
Author: Virgilio Carnielli
Author: Christoph Fusch
Author: Konstantinos Gerasimidis
Author: Johannes B. Van Goudoever
Author: Nadja Haiden
Author: Silvia Iacobelli
Author: Mark J. Johnson
Author: Sascha Meyer
Author: Walter Mihatsch
Author: Miguel Saenz De Pipaon
Author: Jacques Rigo
Author: Gitte Zachariassen
Author: Jiri Bronsky
Author: Flavia Indrio
Author: Jutta Köglmeier
Author: Barbara De Koning
Author: Lorenzo Norsa
Author: Elvira Verduci
Author: Magnus Domellöf
Corporate Author: et al.

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