What is the normal weight progression for a 14-day-old premature infant?

From the Guidelines

A 14-day-old premature infant should typically gain 17-20 grams per kilogram of body weight per day, as recommended by the most recent and highest quality study 1. This growth rate is essential for proper development, particularly brain growth, and to prevent dropping across weight centiles, i.e., growth failure. Premature infants have higher nutritional requirements than term infants due to their immature organ systems and limited nutrient reserves. Adequate nutrition through either fortified breast milk or specialized premature infant formula is crucial to achieve this weight gain. Key factors to consider include:

• Energy intake of 90-120 kcal/kg/day to approximate intra-uterine lean body mass accretion and growth 1
• Protein intake at a level similar to that of a healthy, growing infant of a similar age, ranging from 3 g/kg/day in early infancy to 1.2 g/kg/day in early childhood 1
• Regular weight monitoring (daily or every other day) to ensure the infant is following an appropriate growth trajectory If the infant is not meeting these growth parameters, healthcare providers may need to adjust feeding volumes, increase caloric density, or consider supplemental parenteral nutrition. Inadequate weight gain may indicate feeding problems, increased energy expenditure, or underlying medical issues that require prompt evaluation. It is also important to note that the use of World Health Organization (WHO) growth charts may identify more infants as growing slowly, particularly in the first 3 months of age, and clinicians should carefully assess general health issues and ensure appropriate management of lactation 1.

From the Research

Normal Weight Progression for a 14-Day-Old Premature Infant

• The normal weight progression for a premature infant can vary depending on several factors, including gestational age, birth weight, and nutritional intake 2, 3, 4.
• Studies have shown that premature infants who receive individualized target fortification of breast milk with protein, carbohydrates, and fat tend to have higher weight gain and growth velocity compared to those who receive standard fortification 2.
• The average weight gain velocity for premature infants during the first 28 days of life can range from 15.5-15.8 g/kg/day, depending on the calculation method used 3.
• Weight gain trajectories during different timeframes, such as NICU stay, level-II hospital stay, and at home, can be associated with distinct parameters of body composition in infancy, including fat mass and lean mass 4.
• It's worth noting that the weight progression of a 14-day-old premature infant may not be directly comparable to that of a full-term infant, and individualized growth charts and assessments may be necessary to monitor their growth and development 5, 6.

Factors Influencing Weight Progression

• Gestational age and birth weight can significantly influence the weight progression of a premature infant 2, 5.
• Nutritional intake, including the type and amount of fortification, can also impact weight gain and growth velocity 2, 4.
• The method used to calculate weight gain velocity can also affect the results, and it's essential to use a consistent and reliable method to monitor growth 3.

Monitoring Growth and Development

• Regular weight measurements and growth assessments are crucial to monitor the growth and development of a premature infant 2, 3, 4, 5, 6.
• Individualized growth charts and assessments can help healthcare professionals identify any potential growth restrictions or deviations from expected growth patterns 5, 6.