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*No endorsement of any brand or product by the USDA is implied or intended The Special Nutritional Needs of Premature Infants Premature infants are often discharged from the hospital with a body weight well below that of a healthy term infant at birth2. In fact, studies suggest that premature infants are often discharged weighing little more than half the appropriate weight for a term infant at the equivalent CA2. At hospital discharge, premature infants often have low body stores of nutrients and deficient bone mineralization, plus they need more calories1. That makes sense, given that these babies were born early and without the benefit of the last few weeks of development in the womb. In one study, to be considered premature, the requirement for inclusion was a birth weight below 1750 g2. In the hospital, premature infants receive specially designed preterm infant formulas designed to meet their increased nutritional needs2. They can’t usually stay on these formulas when released from the hospital, however, because there is a real possibility that these concentrated formulas would give them too high levels of some fat-soluble vitamins, which could be dangerous2. Therefore, special nutrient-enriched post-discharge formulas have been developed2. They provide the extra vitamins and nutrients premature infants need, like more protein and calcium. A double-blind, randomized study conducted by Carver et al evaluated the growth of premature infants with birth weights <1800 g who were fed a nutrient-enriched formula (22 Calories/fl oz) or a term formula (20 Calories/fl oz) from hospital discharge to 12 months’ CA1. The results showed that growth was improved in premature infants fed a nutrient-enriched post-discharge formula after hospital discharge to 12 months’ CA1. It is likely that both breastfed and formula-fed premature infants will need nutritional supplementation after hospital discharge2. So it makes sense for this to be a post-discharge formula like Enfamil® EnfaCare®, rather than a standard term formula2 and to have moms continue it until 9 to 12 months’ CA1,2. The Enfamil EnfaCare Differences Enfamil EnfaCare has a more nutrient-dense composition than Enfamil PREMIUM® and was designed to provide added nutrients in the same caloric density, so a premature infant can receive extra nutrients in the same quantity of formula. This can be especially important in tiny stomachs. Protein: The level of protein in Enfamil EnfaCare is 2.8 g/100 Calories, which is 33% more protein than that in Enfamil PREMIUM formulas. Calcium: The calcium level of Enfamil EnfaCare is 120 mg/100 Calories, which is 54% more calcium than that in Enfamil PREMIUM formulas. The calcium:phosphorus ratio is about 1.8:1, similar to that of human milk*. *Data on file, Mead Johnson Nutritionals, October 2005. Weight444 12 Length, cm Weight, kg 10 8 6 4 2 Length444 85 80 75 70 65 60 55 50 45 *No endorsement of any brand or product by the USDA is implied or intended 118 weeks PMA (~18 months corrected age) The Importance of DHA Levels Enfamil formulas with DHA and ARA ‡ ** 79 weeks PMA (~9 months corrected age) Breastfed, full-term infants ‡ Enfamil® Premature, Enfamil EnfaCare and Enfamil PREMIUM® Infant before the addition of prebiotics. PMA = postmenstrual age Enfamil® EnfaCare® has a DHA level similar to the average worldwide level of breast milk†. †Average level of DHA in worldwide breast milk is 0.32%±0.22% (mean ± standard deviation of total fatty acids) based on an analysis of 65 studies of 2474 women. Weight444 12 Length, cm 10 Weight, kg Premature infants fed Enfamil EnfaCare, in a program of Enfamil formulas‡, achieved growth similar to that of healthy breastfed infants4 8 6 4 2 Length444 85 80 75 70 65 60 55 50 45 118 weeks PMA (~18 months corrected age) 79 weeks PMA (~9 months corrected age) Enfamil formulas with DHA and ARA ‡ ** Breastfed, full-term infants ‡ Enfamil® Premature, Enfamil EnfaCare and Enfamil PREMIUM® Infant before the addition of prebiotics. PMA = postmenstrual age Nourish the brain to help premature infants achieve developmental milestones4 Mental Development Index (MDI)4,§ Psychomotor Development Index (PDI)4,§ Studied at 18 months 95 95 90 90 85 P=0.056 80 Studied at 18 months 100 Score Score 100 P<0.05 85 80 75 75 0 0 Enfamil formulas with DHA and ARA‡ Control discontinued Enfamil formulas without DHA and ARA ‡Enfamil® Premature, Enfamil EnfaCare and Enfamil PREMIUM® Infant before the addition of prebiotics. §Some infants in this study were fed formulas supplemented with DHA from a fish source, but data are not shown in the graph. Post-discharge Nutrition Mental Development Index (MDI)4,§ Psychomotor Development Index (PDI)4,§ 85 P=0.056 Score Score 1 Premature infants are discharged increasingly earlier so18proper can beatespecially Studied, at months post-discharge nutrition Studied 18 months 100 100 important. Studies show post-discharge formulas are successful in promoting growth when continued until 9 to 12 months1,2. That’s why continuing to95 feed Enfamil EnfaCare is so important. It’s 95 one less P<0.05thing for new 90 90 moms to have to worry about. 85 Moms can trust Enfamil EnfaCare to nourish support their premature 80 80 their post-discharge preterm infants and help infants in achieving developmental milestones. 75 75 0 0 References: 1. Carver JD, et al. Pediatrics. 2001;107:683-689. 2. Lucas A, et al. Pediatrics. 2001;108:701-711. 3. Greer FR. Semin Perinatol. 2007;31:89-95. Enfamil formulas with DHA and ARA‡ Control discontinued Enfamil formulas without DHA and ARA 4. Clandinin MT, et al. J Pediatr. 2005;146:461-468. ‡Enfamil® Premature, Enfamil EnfaCare and Enfamil PREMIUM® Infant before the addition of prebiotics. §Some infants in this study were fed formulas supplemented with DHA from a fish source, but data are not shown in the graph.