Standardized versus individualized parenteral nutrition in very low birth weight infants: A comparative study

Tatiana Smolkin, Giselle Diab, Irit Shohat, Huda Jubran, Shraga Blazer, Geila S. Rozen, Imad R. Makhoul

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Background: Parenteral nutrition (PN) improves the growth and outcome of very low birth weight (VLBW) infants. Optimal PN composition, standard (STD-PN) or individualized (IND-PN), is still controversial. Aim: To compare IND-PN and STD-PN as to nutritional and growth parameters, complications and cost. Patients and Methods: 140 VLBW infants were studied. Each of the 70 neonates from the IND-PN group was matched with a neonate of similar gestational age (GA; ±4 days) on STD-PN. Data collection included demographic, maternal, intrapartum, neonatal, interventional, growth and nutritional data. Results: Compared to STD-PN infants, IND-PN infants had a significantly lower mean birth weight, greater need for resuscitation at birth and interventions thereafter. Nevertheless, IND-PN infants showed significantly greater weight gain SDS during the 1st week (p = 0.036) and the 1st month of life (p = 0.0004), and higher discharge weight SDS (p = 0.012) and head circumference SDS (p = 0.006). IND-PN infants received higher mean daily caloric intakes. They also had significantly shorter durations of exclusive PN and needed less electrolyte corrections. Conclusions: Compared to STD-PN infants, IND-PN infants achieved significantly better growth without added clinical or laboratory complications, had a shorter period of exclusive PN and less electrolyte corrections. IND-PN, in accordance with the current more aggressive nutritional approach, appears optimal for PN of VLBW infants. Yet, STD-PN with adequate composition is an appropriate alternative.

Original languageEnglish
Pages (from-to)170-178
Number of pages9
Issue number2
StatePublished - Aug 2010
Externally publishedYes


  • Cost-effectiveness
  • Growth
  • Parenteral nutrition, individualized/standardized
  • Premature infant
  • Very low birth weight


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