Post-discharge nutrition strategies compared for long-term growth, allergy, and metabolic risks in preterm children

The increasing survival rates of very preterm infants underscore the critical need to evaluate their long-term health outcomes. Early nutritional intake is a well-established determinant of growth and neurodevelopment in infants, particularly in this vulnerable population. However, the optimal post-discharge nutritional strategies for preterm infants remain a subject of ongoing debate, with varying practices regarding the use of fortified breast milk versus specialized preterm formulas. A significant knowledge gap exists concerning the long-term impact of these early nutritional exposures on the development of conditions such as allergy and metabolic syndrome by school age, which could have profound implications for public health and individual well-being. This study aims to address this gap by following a cohort of preterm children.

This prospective follow-up cohort study enrolled 6-year-old children born preterm in Denmark between 2004 and 2008, originating from four distinct neonatal units. During hospitalization, infants received breast milk with fortification. Upon discharge, participants were allocated to one of three nutrition groups for 4 months: (1) Breastfeeding solely, (2) Breastfeeding with fortification, or (3) Preterm formula (for those unable to breastfeed). At age 6 years, children will undergo comprehensive ambulant controls and examinations, with primary endpoints assessing growth parameters, incidence of allergy, and markers for metabolic syndrome.