Nutritional intake and growth in very low birth weight infants: a comparison of standardized versus parent-led complementary feeding

Abstract

Abstract The complementary feeding (CF) period is critical for ensuring adequate nutrient intake to support optimal growth in very low birth weight (VLBW) infants. This analysis compares nutritional intake and growth across two CF strategies: a standardized, protocol-driven approach and a non-standardized, parent-led approach. Both cohorts included infants with a birth weight <1500 g. The standardized group followed an age-dependent CF protocol utilizing commercial baby jars, whereas the non-standardized cohort practiced parent-led feeding without dietary restrictions. Nutritional intake was assessed using 3-day dietary records. Infants in the non-standardized study had significantly higher intakes of protein, fat, arachidonic and docosahexaenoic acid, while the standardized cohort showed higher iron and zinc intakes from 6 months corrected age onwards. Despite nutritional differences, growth was similar between cohorts. This comparison demonstrates notable differences in nutrient intake between CF approaches and may guide individualized strategies to support the nutritional needs of VLBW infants. Clinical trial registration: Randomized, standardized study: ClinicalTrials.gov: NCT01809548. Non-standardized, prospective study: ClinicalTrials.gov: NCT02936219.