low birth weight

Low birth weight (LBW) affects 15% of newborns and can have negative, widespread, long-lasting effects on their health. A recent review article summarizes clinical and preclinical data to determine the nutrition required to improve the health and growth of LBW newborns.

Infants that are born with a birth weight of less than 2.5 kg are said to have low birth weight (LBW). About 15% of newborns are LBW, often due to preterm birth or intrauterine growth restriction (delayed growth of fetus). There is data to suggest that improper maternal nutrition can not only affect growth in LBW infants but also have a negative impact on the health later in life. A recent review article, published in the British Journal of Nutrition clearly summarizes the data from clinical and animal studies to determine the nutrition required to improve the health and growth of LBW newborns.

In animal models of intra-uterine growth restriction (IUGR), scientists observe that IUGR causes nutrients to be used up by the most vital organs, which results in lower growth hormones and decreased insulin levels. LBW infants do catch up in growth after birth, but since these newborns have abnormally low insulin levels, an overly compensatory diet may lead to insulin resistance and type II diabetes. Additionally, reports have shown that LBW offspring have a higher likelihood of dysfunctions in various organs such as abnormal brain volume and lower bone quality. A study in pigs determined that LBW piglets had thinner intestinal walls, which can affect the ability of the intestine to absorb nutrients from food and lead to feeding intolerance.

It is suggested that LBW infants be supplied essential nutrients by intravenous injection shortly after birth. This has been shown to circumvent feeding intolerance, help with growth, and reduce mortality among many other benefits.These infants can then transition to human milk with supplementation to promote feeding tolerance. Some studies showed that feeding at intervals rather than continuously has been shown to also promote feeding tolerance and accelerate weight gain. Lastly, the review gives an in-depth overview of the different nutrients that are required for proper growth in preterm newborns and identifies nutrients that require further study to determine optimal dosage. Vast numbers of preclinical studies have suggested that additional nutritional supplementation (specific minerals, vitamins, probiotics, hormonal modulators) may be helpful. Further studies are also required to test whether the preclinical findings will translate to humans.

Overall, this review highlights the potential problems that arise from infants who are LBW and the ways that nutrition can overcome these problems. This serves as a reminder that further studies are still required to optimize nutrition in order to bypass the negative effects of preterm birth or intrauterine growth restriction. Following additional research into the effects of certain nutrients, we can incorporate additional components into the diet of LBW infants in the hopes of positively contributing to their growth and health.

Reference: Li N, Wang W, Wu G, Wang J. Nutritional support for low birth weight infants: insights from animal studies. British Journal of Nutrition. 2017 Jun:1-3.

Written by Branson Chen, BHSc

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