Date of Paper/Work


Type of Paper/Work

Scholarly project

Degree Name

Master of Arts in Nursing




Gay Varecka


When a human infant is born prematurely, they are unable to receive the adequate nutrient and mineral requirements from parenteral or enteral sources that would have been provided to them in most intrauterine states. Preterm infants have low birth weights as the majority of fetal weight gain occurs in the third trimester. Term infants can also be growth restricted at birth for reasons pertaining to placental challenges such as pregnancy induced hypertension, arterial venous anastomosis as in to twin transfusion syndrome, or when severe maternal malnutrition exist. While not necessarily preterm, the products of these gestations will need similar nutritional supplementation for growth and healthy neurodevelopment as the preterm infant. The goal of many neonatal advanced practice nurse providers is to maintain growth rates similar to the uterine environment and often times in the face of critical illnesses or challenges. When adequate nutrition is not administered, extra-uterine growth restriction occurs. Growth restriction has been directly correlated to the decreased structure and function of the central nervous system, specifically when the restriction is during critical periods development such as the neonate period. The ability for a preterm infant to grow and have similar organ development at intrauterine rates requires they receive increased amounts of protein, fat, and minerals when compared to newborn term infants.

Extra-uterine growth restriction has a direct correlation to neurodevelopment challenges and is therefore an area of importance to providers caring for these vulnerable infants. Excluding parenteral nutrition, the ways in which neonatal care units provide growth restricted infants these requirements are by enteral administration via a naso/orogastric tube of own mother’s breast milk (OMM), donor breast milk (DBM), and preterm formulas (PF).


Neonatal Nurse Practitioner