الفهرس 
The High Risk NewbornOnly 14 pages are availabe for public view
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Abstract
In this essay we have discussed nutrition of fullterm, preterm and critically ill neonates. In
nutrition of healthy full term newborn breast feeding provides optimal nutrition, protection
against infection, and is a safe reliable food source for babies. Early nutritional support in the
preterm infant is an important intervention and requires careful study as it is likely to influence
both short ami long term health outcomes. The nutritional management of preterm infants may have a
major impact on growth and development. Nutritional support for newborn infant can be done either
enterally, parenterally, each type has its indication, advantage and disadvantage. Total parenteral
nutrition is a mean of nutrition of newborn infant when enteral feeding can not be initiated and is
often required in the first few weeks of life , usually in conjunction with minimal enteral
feeding. Total parenteral nutrition provides the newborn by micronutrients (protein, lipids and
carbohydrates) and macronutrients (vitamins, minerals, trace elements) through intravenous line
access either centerally or peripherally. Weaning the newborn fi·om parenteral nutrition should be
done gradually with slow introduction of enteral feeding. The enteral feeding volume and strength
should be increased gradually until full enteral feeding is reached which provides adequate
requirement for growth and development. Various feeding strategies for preterm infants are
available, including the use of expressed maternal milk, donor human milk, breast milk fortifiers,
adapted formula milks. To initiate enteral feeding the newborn infant should fulfill certain
criteria in order to tolerate enteral feeding and reduce the incidence of necrotizing
enterocolitis. Breast milk is the best nutrition f()J” both fullterm and preterm newborn. Preterm
human milk is slightly different, but this
difference does not clo e the gap of the calculated needs of premature infant so multinutrient
human milk fortifier should be used. There are many benefits for providing human milk for
premature infants. The ideal nutrients are best utilized is fresh or fresh-tl·ozen mother’s milk.
Preterm newborns should be fed human milk when possible, supplemented with fortifier if growth is
suboptimal. A second line for feeding preterm infant when breast milk is not available is the
preterm formula. This type of formula are calories, protein and mineral enriched formula.
Necrotizing enterocolitis is the most common gastrointestinal emergency in the premature infant.
Despite the recent advances of neonatal intensive care, it remains a major health concern in the
intensive care and an important cause of neonatal morbidity and mortality. Early recognition of
symptoms followed by immediate intervention is important, although no clear evidence has proven
that early diagnosis can alter the outcome. Feeding practices in preterm infants vary widely
between and within special care baby units. Nutrient intakes that meet the recommended dietary
intakes take time to establish and are hard to maintain throughout hospital stay. This is
especially true for the critically ill preterm neonate. As a result, a nutrient deficit accrues.
Recommended dietary intakes are based on what is needed for maintenahce of growth, with no
provision to replace the accrued deficit. In addition, nutrition may be therapeutic for premature
neonates by allowing more rapid adaptation to the extrauterine environment. To prevent growth
failure and extrauterine growth restriction, we need to detect nutrient deficiencies early and
act to correct them. Inborn errors of metabolism are inherited disorders in which the body cannot
metabolize the co1nponents of food. Recent advances in diagnosis and treatment· have· improved
significantly the· prognosis for many infants with inborn errors of metabolism. Early clinical
diagnosis is
essential in ensuring that affected infants will receive the benefits of these advances. The
principle of therapy is to prevent the accumulation of the toxic precursor substance by restricting
the substrate in the diet.