Nutritional supplementation according to birth weight
THE CONTEXT
Supplementation differs between infants weighing 1500–2499 g and those weighing less than 1500 g because the smaller infants have inadequate nutrient stores.
Birth weight 1500–2499 g
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These infants are more likely to be born at or near term, at more than 34 weeks of gestation.
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They need vitamin D and iron supplementation.
Birth weight below 1500 g
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These infants are usually born before 32–34 weeks and have inadequate body stores of most nutrients.
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Expressed breast milk has insufficient protein, energy, calcium, phosphorus, iron, zinc, and vitamins D, E, and K for these infants, so they need multi-nutrient supplementation until term gestation.
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Human milk fortifiers can provide additional nutrients through fortification of expressed breast milk. Fortification increases nutrient content without compromising the milk's other beneficial effects.
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Human milk fortifiers do not provide adequate iron; iron must therefore be supplied separately.
Duration of supplementation
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Continue fortification or supplementation of minerals and vitamins in very-low-birth-weight infants until 40 weeks of gestation, corresponding to the expected date of delivery.
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After 40 weeks, only vitamin D and iron need supplementation, as in infants with birth weights above 1500 g.