الفهرس 
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Abstract
Worldwide, more than 20 million (15.5% of all births) are born as low birth weight (LBW) babies and more than 95.6% of them are born in developing countries. Low birth weight babies are defined as babies with birth weight less than 2500 grams. These could be either term small for gestational age (term SGA) or preterm babies (Meharban, 2004).
LBW is one of the most important contributing factors to neonatal and infant death, illness, and malnutrition. Studies show that LBW is also associated with the development of diabetes and heart disease in adulthood. Good feeding practices can reduce the increased risks of morbidity and mortality associated with LBW (WHO & UNICEF, 2004).
Feeding clinically stable preterm infants becomes crucial to replace the accumulated deficit and to prevent morbidities related to postnatal growth failure (Arslanoglu et al., 2010).
Although it is generally agreed that human milk is the ideal source of nutrition for full term neonates, there is controversy regarding human milk as a nutrition source for preterm and low birth weight infants. Opinion varies from its being the best even if it needs the addition of several supplements, to that there is no place for breast milk in preterm nutrition (Singh et al., 2009).
The concern with providing nutrients to preterm infants can be explained by the need to promote the rate of physical growth and development similar to those of intrauterine life at the same gestational age (Morley and Lucas, 2000).
As a source of nutrients for premature infants human milk leaves much to be desired. It provides insufficient amounts of a large number of nutrients when fed at the usual feeding volumes. To prevent poor neurocognitive outcome as well as specific nutrient deficiencies, nutrient fortification of human milk is necessary (Arslanoglu and Moro, 2008).
LBW infant formulas are designed to provide higher energy, protein, vitamins, and minerals than term infant formulas (Klein, 2002).
The aim of this study was to assess whether exclusive breast feeding is enough for optimal growth of low birth weight infants (weighting from 1800gm. to less than 2500gm.) in the first twelve weeks of life or addition of preterm formula is mandatory.
The current study was conducted on 50 apparently healthy low birth weight infants (LBW); their birth weight ranged from 1800 gm. to less than 2500 gm., their gestational age was 35 weeks or more, delivered at the Gynecology and Obstetric Hospital, Ain Shams University during the period between May 2010 and May 2011.
All newborns included in the study had been exclusively breast fed for the first two weeks of life, and then according to the adequacy of breast feeding they were classified into two groups:
group І (Exclusively breast fed group):
Cases with appropriate growth who were continued on exclusive breast feeding.
This group included 18 LBW infants; their birth weight ranged from 1800 gm. to less than 2500 gm. with a mean of 2.16 ± 0.22 kg, their gestational age was 35 weeks or more with a mean of 36.94 ± 1.30 weeks. They were 10 males and 8 females.
group II (Mixed fed group):
Cases with impaired growth who were received preterm formula as a supplementary to breast feeding.
This group included 32 LBW infants; their birth weight ranged from 1800 gm. to less than 2500 gm. with a mean of 2.19 ± 0.18 kg, their gestational age was 35 weeks or more with a mean of 36.47 ± 0.98 weeks. They were 14 males and 18 females.
All subjects included in the study were subjected to: Full history taking and thorough clinical examination. Anthropometric measurements were done at birth and then all infants were reassessed weekly for the first 12 weeks of their life (for weight, length, head circumference, mid-arm circumference and skin fold thickness). Laboratory investigations (CBC, CRP) were done when indicated.
The study has revealed the following results:
• Mixed-fed group showed significantly higher increase in the mean values of weight, length, mid-arm circumference and Skin fold thickness after 12 weeks when compared to exclusively breast fed group (P<0.05).
• Mixed-fed group has significantly higher percentages of preterm and higher percentages of illiterate mothers (P<0.05).
• There was no significant difference between both groups as regards the mean values of weight at birth (P>0.05). Mixed fed group has significantly lower mean values of weight on 2nd and 3rd weeks but significantly higher mean values of weight at 12th week when compared to exclusively breast fed group (P<0.05).
• There was no significant difference between both groups as regards the mean values of length at birth (P>0.05). Mixed fed group showed significantly higher mean values of length at 12th week when compared to exclusively breast fed group (P<0.05).
• There was no significant difference between both groups as regards the mean values of head circumference at birth (P>0.05) and allover the weeks of the study (P>0.05).
• There was no significant difference between both groups as regards the mean values of mid-arm circumference at birth (P>0.05). Mixed-fed group showed significantly higher mean values of mid-arm circumference at 8th and 12th weeks when compared to exclusively breast fed group (P<0.05).
• There was no significant difference between both groups as regards the mean values of Skin fold thickness (P>0.05), although Mixed-fed group showed higher mean values of Skin fold thickness at 12th week when compared to exclusively breast fed group but the difference did not reach a significant level (P=0.12).
• There was no significant difference between both groups as regards the number of attacks of infection (P>0.05).
• The gain in weight, MAC, and SFT were significantly higher in AGA when compared to SGA infants in mixed-fed group (P<0.05),on the other hand the gain in length, HC showed no significant difference (P>0.05).