Figure, Supplemental Digital Content 1: Flow diagram of study participants
Table, Supplemental Digital Content 2: Macronutrient reference values
Fluid Protein
(g.100ml-1)
Fat (g.100ml-1)
Carbohydrate (g.100ml-1)
Energy (kCal.100ml-1) Dextrose (Baxter, NZ)
5% 0 0 5 17
7.5% 0 0 7.5 25.5
10% 0 0 10 34
12.5 % 0 0 12.5 42.5
15% 0 0 15 51
Intravenous amino acid solutions 13
Old protocol IVN 2 0 10 42.2
New protocol IVN 3.8 0 10 49.7
New protocol IVN (<1,000 grams, <72 hours’ postnatal age, central access)
6.79 0 15 78.1
Intralipid (Fresenius Kabi AB, Uppsala, Sweden)
20% Intralipid 0 20 2.2 200
Expressed breastmilk (EBM) 36
Transitional (< day 14) 1.566 3.86 6.89 68
Mature (≥ day 14) 1.357 4.28 7.2 72
Fortifier (Nutriprem, Nutricia,
NZ) 0.8 0 3 16
Formula milk
Term infant formula (Karicare,
Nutricia, NZ) 1.5 3.8 7 68
Preterm formula (Nutriprem,
Nutricia, NZ) 2.4 4.4 7.8 80
Hydrolysed formula (Pepti-
Junior, Nutricia, NZ) 1.9 3.8 7 67
Table, Supplement Digital Content 3: Growth and anthropometry in children exposed to the old or new neonatal nutrition protocols who were assessed at 7 years
Exposed to old protocol
n = 55
Exposed to new protocol
n = 73
OR
(95% CI) P-value *Adjusted OR
(95% CI) * P-value
Growth Weight (kg)
24.26 ± 6.68 25.97 ± 6.99 1.71 (-0.81 – 4.24)
0.18 1.46 (-0.94 – 3.86)
0.23 Weight z-score
-0.11 ± 1.47 0.37 ± 1.38 0.48 (-0.04 – 1.00)
0.07 0.41 (-0.08 – 0.90)
0.10 Height (cm)
122.7 ± 5.8 124.4 ± 6.1 1.7 (-0.5 – 3.9)
0.13 1.5 (-0.7 – 3.6) 0.19 Height z-score
0.02 ± 1.02 0.34 ± 1.16 0.33 (-0.08 – 0.73)
0.11 0.29 (-0.11 – 0.69)
0.15 Leg length (cm)
55.5 ± 3.3 56.3 ± 3.5 0.8 (-0.5 – 2.1)
0.22 0.6 (-0.6 – 1.9) 0.32 Leg length z-score
-0.35 ± 0.99 -0.11 ± 1.14 0.24 (-0.16 – 0.64)
0.24 0.21 (-0.18 – 0.61)
0.29 Sitting height (cm)
67.2 ± 3.4 68.0 ± 3.1 0.8 (-0.4 – 2.0)
0.20 0.7 (-0.5 – 1.9) 0.27 Sitting height z-
score 0.40 ± 1.07 0.63 ± 1.03 0.23 (-0.16 –
0.62)
0.25 0.23 (-0.17 – 0.62)
0.26 Head
circumference (cm)
51.7 ± 1.7 51.9 ± 2.1 0.2 (-0.5 – 0.8)
0.59
0.0 (-0.6 – 0.7)
0.92
Head
circumference z- score
-1.10 ± 1.13 -0.98 ± 1.57 0.13 (-0.34 – 0.59)
0.60 0.06 (-0.41 – 0.52)
0.81
Body Mass Index
(BMI) (kg.m-2) 15.9 ± 3.1 16.6 ± 3.2 0.7 (-0.5 –
1.9) 0.23 0.6 (-0.5 – 1.7) 0.29
BMI z-score -0.18 ± 1.49 0.25 ± 1.37 0.43 (-0.09 – 0.95)
0.10 0.36 (-0.12 – 0.85)
0.14 Abnormal BMI
15 (27%) 19 (26%) 0.94 (0.42 – 2.11)
0.88 0.93 (0.42 – 2.07)
0.85
Obese 3 (5%) 7 (10%) - -
Overweight 8 (15%) 11 (15%) - -
Thin 4 (7%) 1 (1%) - -
Abdominal circumference (cm)
56.8 ± 8.0 58.5 ± 9.1 1.7 (-1.5 –
4.9) 0.31 1.5 (-1.6 – 4.5) 0.34
Abdominal circumference z-score
0.53 ± 1.49 0.86 ± 1.39 0.33 (-0.20 –
0.85) 0.22 0.29 (-0.20 –
0.78) 0.25
Waist: height ratio 0.46 ± 0.05 0.47 ± 0.06 0.01 (-0.01 –
0.03) 0.48 0.01(-0.01 –
0.03) 0.51
Change in z-scores (birth to age 7)
Weight -0.21
(-0.98–0.80)
0.16 (-0.65 – 1.01)
0.40 (-0.12 –
0.93) 0.14 0.41 (-0.08 –
0.90) 0.10
Height 0.11 ± 1.31 0.30 ± 1.37 0.19 (-0.30 –
0.68) 0.45 0.21 (-0.25 –
0.67) 0.37
Head
circumference -1.41 ± 1.33 -1.14 ± 1.56 0.28 (-0.24 –
0.79) 0.29 0.24 (-0.23 –
0.72) 0.32
Body composition n = 53 n = 71
Fat mass (kg) 4.78 ± 4.14 5.48 ± 4.72 0.70 (-0.98 –
2.37) 0.42 0.65 (-0.95 –
2.24) 0.43
Fat mass, adjusted for height and lean mass#
5.26 ± 0.43 5.12 ± 0.38 -0.14 (-1.29 –
1.01) 0.82 0.13 (-0.90 –
1.16) 0.81
Android/gynoid fat
ratio 0.30 ± 0.11 0.32 ± 0.11 0.02 (-0.02 –
0.06) 0.26 0.01(-0.01 –
0.06) 0.21
Lean mass (kg) 18.42 ± 2.92 19.09 ± 2.87 0.67 (-0.39 –
1.73) 0.22 0.37 (-0.59 –
1.32) 0.45
Height adjusted
lean mass# 18.84 ± 0.24 18.78 ± 0.21 -0.06 (-0.73 –
0.61) 0.86 -0.19 (-0.79 –
0.41) 0.53
Bone mineral density (g.cm-3)
0.67 ± 0.06 0.69 ± 0.05 0.02 (-0.00 –
0.04) 0.06 0.02(-0.00 –
0.04) 0.10
Height adjusted bone mineral density#
0.68 ± 0.01 0.69 ± 0.01 0.01(-0.01 –
0.03) 0.27 0.01(-0.01 –
0.02) 0.30
Central fatness (android fat mass, adjusted for height, lean mass and gynoid fat mass) #
412 ± 13 437 ± 11 25.13 (-9.25 –
59.51) 0.15 26.76 (-8.22 –
61.74) 0.13
Data are n (%), mean ± SD, median (IQR), odds ratio or mean difference (95% CI), or # Standard regression-adjusted mean ± (SE). Children exposed to the old protocol is the reference group.
* Adjusted for sex and birthweight z-score
