Nutritional Management of the Neonate

Joan Y. Meek MD, MS, RD, IBCLC

Caloric Requirements:
Maintenance: 50-60 kcal/kg/day Adequate weight gain: Term infant: 110-120 kcal/kg/day -- gain 15-30 g/day Preterm infant: 110-140 kcal/kg/day -- gain 15 g/day

Weight:
Weight loss of 5-7% birth wt in first 3-4 days. Weight gain begins no later than day 7 of life. Return to birth weight by 14 days of life.

Fluid requirements:
First day: 70-80 ml/kg/day Second day: 85-90 ml/kg/day Third day: 100 ml/kg/day Gradual increase to 150-200 ml/kg/day

Criteria for initiating infant feeding:

Absence of excessive oral secretions, vomiting, or bilious NG aspirates Nondistended, soft abdomen with normal bowel sounds Respiratory rate: Less than 60 bpm for oral feeding Less than 80 bpm for gavage feeding