The Role of Nutrition in the Prevention and Management of Bronchopulmonary Dysplasia: A Literature Review and Clinical Approach

Gustavo Rocha, Hercília Guimarães and Luís Pereira-da-Silva
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Gustavo Rocha: Department of Neonatology, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
Hercília Guimarães: Department of Neonatology, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
Luís Pereira-da-Silva: Comprehensive Health Research Centre (CHRC), NOVA Medical School|Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal

IJERPH, 2021, vol. 18, issue 12, 1-20

Abstract: Bronchopulmonary dysplasia (BPD) remains the most common severe complication of preterm birth, and nutrition plays a crucial role in lung growth and repair. A practical nutritional approach for infants at risk of BPD or with established BPD is provided based on a comprehensive literature review. Ideally, infants with BPD should receive a fluid intake of not more than 135–150 mL/kg/day and an energy intake of 120–150 kcal/kg/day. Providing high energy in low volume remains a challenge and is the main cause of growth restriction in these infants. They need a nutritional strategy that encompasses early aggressive parenteral nutrition and the initiation of concentrated feedings of energy and nutrients. The order of priority is fortified mother’s own milk, followed by fortified donor milk and preterm enriched formulas. Functional nutrient supplements with a potential protective role against BPD are revisited, despite the limited evidence of their efficacy. Specialized nutritional strategies may be necessary to overcome difficulties common in BPD infants, such as gastroesophageal reflux and poorly coordinated feeding. Planning nutrition support after discharge requires a multidisciplinary approach to deal with multiple potential problems. Regular monitoring based on anthropometry and biochemical markers is needed to guide the nutritional intervention.

Keywords: bronchopulmonary dysplasia; enriched formulas; fluid restriction; growth monitoring; human milk fortification; preterm infants (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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