Feeding Practices and NutritionalEvolution of Preterm Infants duringHospitalization: a Longitudinal Study

Objectives: To compare feeding practices and anthropometric variables between preterm infants, according to the degree of prematurity, during hospitalization until hospital discharge, and to correlate these practices with nutritional evolution. Methods: Prospective study with 44 premature infants admitted to a referral hospital for the care of high-risk newborns, in the interior of Pernambuco, between 2016 and 2017. The data analyzed were obtained by consulting medical records to compare birth characteristics, feeding practices, and anthropometric measurements between preterm infants ≤ 33 and ≥ 34 weeks of gestational age. Results: Parenteral nutrition and the start of full enteral nutrition were similar between groups. Premature infants with a gestational age ≥ 34 weeks had an earlier onset and shorter use of enteral nutrition (1; 0-2 vs. 0; 0-1, p=0.002 and 25; 5-36 vs. 7; 1-24, p <0.0001, respectively), started oral feeding earlier (7.5; 2-32 vs. 4.5; 1-24, p=0.019), and had a higher prevalence of exclusive breastfeeding at hospital discharge (56.2% vs. 76.2%, p=0.0017). Those with a gestational age ≤ 33 weeks presented a greater need for human milk fortification (57.0% vs. 16.0%, p<0.0001) and longer hospital stay (31; 10-55 vs. 12.5; 3-55, p = 0.0001). There was a positive correlation between the start of enteral nutrition and the hospitalization time (r=0.410, p=0.007). Conclusion: Physiological maturity seems to influence dietary practices and nutritional evolution during the hospitalization of premature infants. The start of enteral nutrition, as observed in this study, is positively correlated with the length of hospital stay. These findings may contribute to improvement in nutritional care for premature infants.