The role of nutrition in the prevention and management of bronchopulmonary dysplasia.

Nutrition plays a critical role in the prevention and management of bronchopulmonary dysplasia (BPD). Growth failure in infants with BPD is predominantly due to malnutrition. Malnutrition can worsen BPD by compromising lung growth. Feeding difficulties in these infants can further affect nutrition. Dexamethasone, used to facilitate extubation and treat severe BPD, is known to have adverse effects on growth. Nutritional management of very low birth weight (VLBW) infants should be addressed from the first day of life to enhance growth and minimize respiratory morbidity. Fluid restriction, parenteral nutrition with protein and lipids, and early enteral feeding may help decrease the incidence of BPD. High calorie concentrated formula can be used in infants to achieve adequate growth if total daily fluid intake is restricted. Vitamin A supplementation may help to prevent further damage to lungs. The role of such therapies as inositol, vitamin E, and selenium in management of these infants remains speculative. Close post discharge follow up of infants with BPD is necessary to monitor growth and to ensure intake of sufficient protein and calories.