Upgrade to nutriprem range formulations helps neonatal teams meet ESPGHAN nutrition guidelines
Cow & Gate has upgraded the recipes within its nutriprem range of formula milks. The move aims to help healthcare staff meet new European guidelines on the nutritional needs of preterm infants.
The guidelines, published by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)1 and based on scientific research and expert opinion, aim to provide guidance on the nutrient needs of preterm infants to achieve growth similar to foetal growth as well as satisfactory functional development. Thus they have recommended intakes for a wide variety of nutrients including protein, fat, long chain polyunsaturated fatty acids (LCPs), calcium and phosphorus.
Upgrading the recipes of Cow & Gate breastmilk fortifier and nutriprem 1 will provide neonatal teams with the only preterm range that is compliant with the ESPGHAN 2010 guidelines.
Meeting the ESPGHAN 2010 nutritional guidelines
The recommendations for enteral intakes can be achieved in different ways including:
- For infants receiving breastmilk and weighing 1kg-1.8kg, using Cow & Gate breastmilk fortifier can provide the following intakes (see table 1)
- For formula-fed preterm infants weighing 1kg-1.8kg, Cow & Gate nutriprem 1 will help meet the ESPGHAN recommendations (see table 2)
The importance of energy and protein1
- The recommendations are based upon mimicking intrauterine growth and nutrient retention, whilst taking into account differences in nutrient supply and metabolism and the extrauterine environment.
- New tissue synthesis is particularly energy intensive and is strongly affected by the intake of protein and other nutrients
- Achieving an adequate energy to protein ratio is as important as providing adequate energy intake alone
- An energy intake >100kcal/kg-1/day-1 is considered appropriate in infants receiving a formula that provides adequate protein to energy ratio (>3-3.6g/100kcal) and well-absorbed nutrients. This may lead to a fat mass percentage closer to both normal term infants and intrauterine references.
- It is common for small preterm infants to accumulate protein deficits. Their protein intake needs to compensate for this, thus the guidelines recommend a range
of 3.5-4.5g protein/kg/day.
- As some excesses of protein intakes have not been shown to be detrimental, yet small deficits will impair growth, the guidelines recommend the higher end of the protein range for those <1000g compared to those >1000g.
Cow & Gate: Innovation based on science
 A unique patented blend of prebiotic oligosaccharides
- Mimics the function of natural oligosaccharides found in breastmilk5,6
- Provides functional and clinical benefits such as improved stool consistency and enteral tolerance in preterm infants5-8
New BPA free plastic bottles
- Shock-resistant reducing the risk of breakages
- Reduction in noise in the hospital environment
- Lighter, more ergonomic design
- Bisphenol A (BPA)-free and phthalate-free
- Now available in 70ml (nutriprem 1) and graduated to show every 5ml of milk
- Same shelf life as glass bottles
- Store in conditions under 25°C
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Visit our preterm product section for more information on the Cow & Gate nutriprem range including downloadable datacards that detail nutritional content and composition.
References: 1. Agostoni C et al. Enteral nutrient supply for preterm infants: Commentary from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2010;50:85-91. 2. Mean values for preterm breastmilk taken from 1) Tsang R, Uauy R, Koletzko B, Zlotkin S, eds. Nutrition of the preterm infant. Scientific basis and practical guidelines. OH: Digital Educational Publishing, 2005; 2) Klein CJ, ed. Nutrient requirements for preterm infant formulas. J Nutr 2002;132:1395S-577S and 3) Geigy Scientific Tables 1975, 7th ed. Basel, Switzerland: Ciba-Geigy Ltd. 3. Knol J et al. Increase of faecal bifidobacteria due to dietary oligosaccharides induces a reduction of clinically relevant pathogen germs in the faeces of formula-fed preterm infants. Acta Paediatr 2005;94(449):31–3. 4. Boehm G et al. Supplementation of a bovine milk formula with an oligosaccharide mixture increases counts of faecal bifidobacteria in preterm infants. Arch Dis Child Fetal Neonatal Ed 2002;86:F178-81. 5. Mihatsch W et al. Prebiotic oligosaccharides reduce stool viscosity and accelerate gastrointestinal transport in preterm infants. Acta Paediatr 2006;95:843-8. 6. Modi N et al. A randomised,
double-blind, controlled trial of the effect of prebiotic oligosaccharides on enteral tolerance in preterm infants. Pediatr Res 2010;68:440-5.
*Compliant for infants weighing 1-1.8kg.Important notice: Cow & Gate nutriprem 1 is a food for special medical purposes and should only be used under medical supervision, after full consideration of the feeding options available including breastfeeding. Cow & Gate nutriprem 1 is suitable for use as the sole source of nutrition for preterm and low birthweight infants. This product is not for parenteral use.
