The following is a summary of “Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts,” published in the February 2023 issue of Gastroenterology and Nutrition by Embleton, et al.

For a study, researchers sought to develop a consensus on nutrient intakes and nutritional practices for preterm infants with birth weight less than 1800g by reviewing current literature. 

The European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee of Nutrition (CoN) was responsible for leading the process, which involved CoN members and invited experts. The experts were chosen to represent a broad geographical spread and had specific expertise in their respective fields. The topics were assigned to individual leads, and the members reviewed the current literature. A single face-to-face meeting was held in February 2020, and provisional conclusions and recommendations were developed between 2020 and 2021.

The recommendations were voted on electronically by all members of the working group between 2021 and 2022, and online discussion meetings were held where >90% consensus was not achieved. The results showed that there is a lack of strong evidence for most nutrients and topics. However, the summary paper was supported by additional supplementary digital content that provides a fuller explanation of the literature and relevant physiology. This included an introduction and overview, human milk reference data, intakes of water, protein, energy, lipid, carbohydrate, electrolytes, minerals, trace elements, water-soluble vitamins, and fat-soluble vitamins. It also included feeding modes, such as mineral enteral feeding, feed advancement, management of gastric residuals, gastric tube placement, and bolus or continuous feeding. Furthermore, it covered growth, breastmilk buccal colostrum, donor human milk, risks of cytomegalovirus infection, hydrolyzed protein, and osmolality, supplemental bionutrients, and the use of breastmilk fortifier. 

In conclusion, the study provided updated ESPGHAN CoN consensus-based conclusions and recommendations on nutrient intakes and nutritional management for preterm infants. However, due to the lack of strong evidence for most nutrients and topics, it was important to continually review and update the recommendations as new evidence becomes available.

Reference: journals.lww.com/jpgn/Fulltext/2023/02000/Enteral_Nutrition_in_Preterm_Infants__2022___A.23.aspx