After NICU Discharge: Preterm Infant Feeding and Growth Through the First Year

ABSTRACT Background Little is known about preterm infant feeding and growth in the outpatient community setting and there are no standardized post-hospital discharge feeding guidelines. Objective To describe the post-neonatal intensive care unit (NICU) discharge growth trajectories of very preterm (<32 weeks gestational age (GA)) and moderately preterm (32-34 6/7 weeks GA) infants managed by community pediatric providers and to determine the association between post-discharge feeding type and growth Z-scores and z-score changes through 12 months corrected age (CA). Methods Very preterm infants (n=104) and moderately preterm infants (n=109) born 2010-2014 and followed in hospital-affiliated community health clinics were enrolled in a single-center retrospective cohort study. Infant home feeding type and anthropometry were abstracted from outpatient medical chart review, and repeated measures analysis of variance calculated adjusted growth z-scores and z-score differences between 4 and 12 months CA. Linear regression models tested the relationship between type of home feeding at 4 months CA and anthropometry at 12 months CA. Results By 12 months CA, 5% of very preterm and 10% of moderately preterm infants were overweight. Moderately preterm infants on nutrient-enriched vs. standard term feeds had lower length z-scores at 12 months CA (−0.04 vs. 0.37, P=.03). Feeding type at 4 months CA predicted 12 month CA body mass index z-scores for very preterm infants (β=-0.66(−1.28, -0.04)). Conclusion Community pediatric providers may manage preterm infant post-NICU discharge feeding in the context of growth. Further research is needed to explore modifiable drivers of obesity risk in preterm infants to optimize infant development.