Protein Needs of Preterm Infants: Why Are They So Difficult to Meet?

Because of their exceedingly high rate of growth, premature infants have very high needs for all nutrients. Requirements have been estimated by the factorial method based on the body composition of the fetus. Failure to meet the high requirements for protein impairs growth and places the infant at risk of neurodevelopmental impairments. Human milk, the preferred feeding for premature infants because of its protective effects, does not provide adequate amounts of nutrients and must be fortified. On the basis of studies performed several decades ago using very high protein intakes, in the past it has been believed that protein intakes that met the high needs of premature babies are dangerous for premature babies. To prevent protein intakes from being too high, the protein content of fortifiers in the past has been kept low. Today, this fear of protein is still the reason why protein intakes tend to be kept low, with the result that protein intakes are often too low.