Randomized trial of enteral protein and energy supplementation in infants less than or equal to 1250 g at birth

Objective:to determine if enteral protein and energy supplementation would significantly improve weight gain as compared with energy supplementation alone in ⩽1250 g infants.study design:inclusion criteria were birth weight (bw) ⩽1250 g, postnatal age ⩾14 days, diet of ⩾75% enteral nutrition (fortified human milk or formula) and either failure to regain bw or weight gain<15 g kg−1 per days. infants were randomized to a multinutrient supplement that provided increased protein and energy (p/e) intake or energy alone (medium chain triglyceride oil, mct). growth rates were compared at the end of the 4-week study period.result:of 30 eligible infants, 23 were enrolled, 12 received mct (bw=862±252 g, mean±s.d.) and 11 received p/e (bw=879±241 g). significantly higher protein intake (p/e=3.5±0.3 g kg−1 per day, mct=3.0±0.5 g kg−1 per day) and better growth (p/e=17.0±2.4 g kg−1 per day, mct=11.5±4.8 g kg−1 per day) were observed in the p/e group.conclusion:these data are consistent with the importance of providing additional daily protein intake to achieve increased postnatal growth in very low birth weight infants experiencing slow growth.