Growth outcomes of very low-birth weight infants in the newborn intensive care unit

The American Academy of Pediatrics Committee on Nutrition advocates that the goal of nutritional management of very low-birth weight infants be to achieve postnatal growth at a rate that approximates the growth of a normal fetus at the same postconceptional age. Although optimal nutrition for very low-birth weight infants has not been defined, reports of longitudinal growth of hospitalized infants have demonstrated that current nutritional practices permit growth at rates that approximate the intrauterine growth rate once birth weight is regained. Unless growth exceeds the intrauterine rate, however, most very low-weight infants fail to achieve catch-up growth, and are below the 10th percentile body weight of the reference fetus at the same postconceptional age. This article discusses this seeming paradox and concludes with a challenge to identify ways to improve the growth of very low-birth weight infants.