Nutritional strategies and their influence on growth and body composition in moderate and late preterm infants: a systematic review of recent literature

PURPOSE OF REVIEW: While moderate and late preterm infants (MLPTI, gestational age 32 0/7-36 6/7 weeks) represent the largest group of preterm infants worldwide, studies on nutritional needs remain scarce. This review evaluated the latest evidence on nutritional strategies for MLPTI and their effect on growth and body composition. RECENT FINDINGS: For the first time, specific recommended nutritional intakes were defined by a group of experts, resulting in a recommended protein intake of 3.1-3.5 g/kg/day and a recommended energy intake of 127-130 kcal/kg/day. However, most MLPTI fail to meet these targets in the first week of life. Higher early protein and energy intakes were associated with improved weight gain, head growth, and reduced extra-uterine growth restriction in the first months of life, but data beyond those first months were limited. Feeding type also influenced outcomes: infants who were exclusively fed mother's milk showed lower fat mass and higher lean mass compared to those receiving formula. SUMMARY: Nutrition in MLPTI is critical for early growth and body composition. Breastfeeding support and adequate early protein and energy intake appear beneficial for early growth. Further longitudinal studies are needed to clarify the lasting impact of early nutrition on growth and body composition in MLPTI.