Doctors tested a new method for feeding premature babies who were born smaller than expected. They compared two groups of 50 babies each. One group received nutrition calculated based on their actual birth weight, while the other group received nutrition calculated using a special formula that adjusted for their size. After several weeks, the babies in the adjusted nutrition group gained more weight—about twice as much as the other group. This suggests that using a smarter calculation method, with help from a computer system, might help premature babies grow better and stronger.

The Quick Take

  • What they studied: Whether a special way of calculating nutrition for premature babies (using adjusted weight measurements) helps them gain weight faster than the standard method
  • Who participated: 100 premature babies who were born smaller than normal for their age. The babies were split into two equal groups of 50, and the groups were similar in age, sex, and birth weight at the start
  • Key finding: Babies who received nutrition based on the adjusted weight calculation gained about 0.16 kg compared to 0.09 kg in the standard group—roughly twice as much weight gain. The adjusted group also showed a 13.6% increase in body weight versus 6.4% in the standard group
  • What it means for you: If you have a premature baby in the hospital, this research suggests asking your medical team about using adjusted nutrition calculations. This appears to be a safe way to help your baby grow better, though more research is still needed to confirm these benefits in larger groups of babies

The Research Details

This was a carefully designed experiment where researchers randomly divided 100 premature babies into two groups. Both groups received intravenous nutrition (food delivered through a tube into the bloodstream) because premature babies often can’t eat normally at first. The key difference was how doctors calculated how much nutrition each baby needed. The control group’s nutrition was based on the baby’s actual weight at birth. The intervention group’s nutrition was calculated using a special adjusted weight formula—specifically, the weight that would be normal for a baby at the 10th percentile (meaning smaller than average, but still healthy). A computer system helped doctors make these calculations accurately. Researchers measured how much weight, length, and head size each baby gained from the start until they could eat regular food by mouth.

This research approach is important because premature babies, especially those born smaller than expected, need very careful nutrition planning. Too little nutrition and they don’t grow; too much can cause problems. By testing whether an adjusted calculation method works better, researchers can find the best way to help these vulnerable babies. Using a computer system to help with calculations reduces human error and makes the method consistent across different hospitals

This study is a randomized controlled trial, which is one of the strongest types of research. The two groups started out very similar, which is good. The study was registered on ClinicalTrials.gov, showing transparency. However, the sample size of 100 babies is moderate—larger studies would provide even stronger evidence. The study measured clear, objective outcomes (actual weight gain), which is reliable. The fact that results were statistically significant (p-values less than 0.05) means the differences weren’t likely due to chance

What the Results Show

The main finding was that babies receiving nutrition based on the adjusted weight formula gained significantly more weight than babies receiving standard nutrition. The adjusted group gained a median of 0.16 kg (about 5.6 ounces) while the standard group gained 0.09 kg (about 3.2 ounces). When looking at the percentage of weight gained relative to starting weight, the adjusted group increased by 13.6% compared to just 6.4% in the standard group. This difference was statistically significant, meaning it’s unlikely to have happened by chance. The adjusted calculation method, combined with computer assistance, appears to provide the right amount of nutrition for these smaller babies to grow optimally.

While the abstract focuses on weight gain, the researchers also measured length and head circumference growth, though specific results for these measurements weren’t detailed in the summary. These measurements are important because they indicate overall healthy growth, not just weight gain. The fact that both groups started with no significant differences in gestational age, sex, or birth weight strengthens confidence that the weight gain difference was due to the nutrition method, not other factors

This research builds on existing knowledge that premature babies need careful nutrition planning. Previous studies have shown that underfeeding premature babies can slow their growth and development, while overfeeding can cause complications. This study suggests that using an adjusted weight calculation—rather than actual birth weight—may be the ‘sweet spot’ for nutrition. The use of a computer decision support system is a modern approach that adds precision to an older concept of adjusted nutrition calculations

The study included only 100 babies, which is a moderate sample size. Larger studies with more babies would provide stronger evidence. The study measured outcomes only until babies could eat regular food, so we don’t know if benefits continue long-term. The study was conducted in a specific setting with a specific computer system, so results might differ in other hospitals or countries with different practices. The study doesn’t explain why the adjusted weight method works better—just that it does. More research is needed to understand the mechanism and to test this approach in different populations of premature babies

The Bottom Line

Healthcare providers caring for premature babies born smaller than expected may consider using adjusted weight calculations for nutrition planning, with computer assistance if available. This approach appears safe and shows promise for improving weight gain. However, this should be done under medical supervision and tailored to each baby’s individual needs. Confidence level: Moderate—this is a good quality study, but larger studies would increase confidence

Parents of premature babies, especially those born smaller than expected, should know about this research. Neonatal intensive care unit (NICU) doctors and nurses should consider this approach. This research is less relevant for full-term babies or premature babies of normal weight. Babies with specific medical conditions may need different nutrition approaches

In this study, weight gain differences appeared over several weeks—the time it took for babies to develop enough to eat regular food (typically 2-4 weeks for premature babies). Parents shouldn’t expect overnight changes, but should see measurable improvement in growth over the course of the baby’s NICU stay

Want to Apply This Research?

  • If your baby is in the NICU, ask your medical team for weekly weight measurements and calculate the percentage change from birth weight. Track this in a simple spreadsheet or note app: Date | Weight (kg) | % Change from Birth Weight. This lets you see growth trends over time
  • Work with your NICU team to ensure nutrition calculations are being done using the most current, evidence-based methods. Ask specifically whether adjusted weight calculations are being used. Keep detailed records of your baby’s nutrition plan and growth measurements to discuss with your care team
  • Request growth charts from your hospital that show weight, length, and head circumference over time. Compare these to standard growth charts for premature babies (adjusted for prematurity). Continue monitoring growth after discharge from the hospital, as catch-up growth typically continues for the first 2-3 years of life

This research is about specialized nutrition for premature babies in hospital settings and should only be applied under direct medical supervision by qualified healthcare providers. Parents should not attempt to adjust their baby’s nutrition based on this research alone. Always consult with your baby’s NICU team before making any changes to nutrition plans. This study shows promising results but is not yet standard practice everywhere—discuss with your medical team whether this approach is appropriate for your baby’s specific situation. Individual babies have different needs, and what works for one baby may not work for another.