Very low birth weight (VLBW) infants are considered those neonates born less than 1.5 kg. Although only one percent of newly born infants are born at such low birth rates, this group claims 50 percent of all infant deaths.
VLBW infants frequently have a range of issues due to immature function of various organs. Numerous cases indicate that disastrous outcomes can result when these infants don’t receive adequate nutrition during the first few days after birth. Therefore, one of the primary goals is to provide suitable nourishment and then to encourage weight gain.
In a recent randomized controlled pilot study, published in the British Medical Journal, 2016, researchers evaluated weight gaining, length of hospitalization and the oxidative stress related diseases (OSRDs), including retinopathy of prematurity, bronchopulmonary dysplasia, periventricular leukomalacia and necrotizing enterocolitis, of VLBW infants.
In the study there were 26 VLBW infants divided into two groups: Group 1 received enteral nutrition plus extra virgin olive oil (EVOO), and group 2 received enteral nutrition alone. EVOO was added to the enteral nutrition at a rate of 0.5 ml/day in 100 ml enteral nutrition. Group 1, the EVOO group, gained an average 1,329 g, group 2 gained 1,276 g.
Though there was no significant difference between the two groups, the authors state that, “EVOO contains very important natural antioxidant and anti-inflammatory nutrients for preterm infants particularly VLBW.” They suggest that larger randomized trials are needed to determine the “antioxidant and anti-inflammatory effects of olive oil for prevention of OSRDs in this high risk group.”
A single blind randomized controlled trial, published in the Journal of Family and Reproductive Health, evaluated the effect of olive oil (OO) as a supplement to breast milk in increasing the weight gaining of VLBW infants.
In this study there were 48 VLBW infants divided into two groups: Group 1 received OO added to the breast milk (0.5 cc per 30 cc of milk), and group 2 received breast milk only with no supplementary nutrition. Both groups received a daily feeding volume of 150-200 cc for each kilogram of body weight.
The weight of group 1 went from 1,184 g at birth to 1,425 g at discharge, group 2 went from 1,293 g at birth to 1,410 g at discharge – a 280 g weight gaining in group 1 (the OO group) compared to just 117 g in the control group 2. Hospitalization time was also lower in group 1, 20.33 days, compared to 28.29 days in group 2. The authors attributed this to an increased improvement in immune system function in group 1.
Further to this a review published last year in Clinical Medicine Insights: Pediatrics looked in-depth at the use of intravenous lipids for very low birth and other critically ill neonates.
According to the authors, there is a reluctance to use early intravenous lipids. Therefore the review investigated lipid biochemistry and metabolism of lipids, origins of current clinical practice, various clinical concerns that may arise, and delved into a review of the literature to establish some clarity in this controversial area.
Based on the words of professor Josef Neu, the authors concluded that, “there are compelling reasons for early use of lipids, which include prevention of essential fatty acid (EFA) deficiency, provision of energy, and provision of substrates for long chain polyunsaturated fatty acid (LCPUFA) synthesis all of which are important for the growth and development of VLBW infants.”
It certainly appears we need more research in this area to establish any definitive practices to aid the health and development of VLBW infants. However, taking the randomized trials into consideration, the health benefits of EVOO for low birth weight infants seems to deserve further exploration.
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