Protein Requirement In Preterm Babies: How Much Is Needed? How Much Is Enough?

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Proteins are complex substances that are essentially the building blocks of the human body. These are organic compounds made up of carbon, hydrogen, nitrogen, and sulfur and are necessary for growth and development, not just for young children, but also for newborns who receive their daily dose of protein from human milk. It is clinically proven that deficiency in protein leads to many illnesses ranging from skin conditions to stunted growth in children.

However, it should be kept in mind that protein requirement in preterm babies is different from those of full-term babies, and needs to be actively monitored.

Clinical recommendations

According to the American Academy of Pediatrics, protein helps to achieve normal intrauterine growth rates, along with shaping a healthy body composition and creating normally functioning cells, tissues, and organs. Recent studies have also established that the brain volume of preterm babies is significantly lower by around 40%, which poses a threat to the baby reaching developmental milestones on time.

Let us learn more about the protein requirement in preterm babies

How To Meet The Protein Requirement In Preterm Babies?

Preterm babies are born before their due dates and thereby miss out on the critical last few weeks in the mother’s womb. Therefore, an adequate amount of Protein should be supplied to infants from birth to facilitate optimal growth and development. As long as the amount of protein is supplied at rates equivalent to what the baby would have received in the mother’s womb, the growth deficits of sub-optimal protein intake can be avoided.

Human milk is recommended by most doctors for feeding preterm infants. However, it should be noted that the protein content in human milk keeps varying with time over the entire lactation period. Thus, breast milk alone may not be sufficient to meet the nutritional requirements of the growing preterm infant.

To help fulfill the protein requirements, and also to encourage optimum health and long-term development, a fortifier can be added to human milk while feeding preterm babies. Supplemental protein in the form of high-quality liquid or powder should be taken at the advice of a pediatrician.

However, additional protein should be given with great caution, as too much protein, just like less protein, can be equally harmful in the long run. Research has indicated that ‘positive protein balance’ requires at least 1.5 g/kg/day of protein for full-term babies.

 Can Too Much Protein Be Harmful To Preterm Babies?

The usual way to determine growth is by observing a baby’s weight. While it indicates the general well-being, it is not necessarily an indication of whether actual development is taking place or whether the infant is getting the right nutrients for its development. This happens as many preterm babies are erroneously fed more than necessary in the hope that the baby gains maximum weight and catches up with the prescribed weight ranges for full-term babies.

The optimum amount of protein in a baby’s diet is influenced by multiple factors like gestation age, weight, feed volumes etc. and your pediatrician is best suited to guide you.

Our Two Cents

Strict adherence to balanced diets for mothers, supplemental protein in the form of fortifiers, and engaging with more brain development activities can help in the comprehensive development of a preterm baby.

Complementing Human milk with fortifiers can be beneficial to babies as they provide multiple nutrients that may be missing or in low amounts in breast milk. There are numerous ongoing researches being undertaken to identify and accurately list the relation between the amount of protein in fortifiers, and the appropriate type of fortifier as per the age group and requirement of the baby.

However, till the time such fortifiers become mainstream, it is essential that preterm babies receive 100% human milk and for additional nutrition requirements, balance it with fortifiers derived from human milk for its overall growth and development.


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