Table 1.

Preventive nutritional approach in infants at high risk of BPD.

Intervention		Reference
Avoid excessive fluid intake	−In the first postnatal day: 80–100 mL/kg/day −After the first postnatal week: 135–150 mL/kg/day	[32,33,34]
Provide adequate incubator humidity	−In the first postnatal week: 60–70%	[37]
Maintain adequate temperature	−Abdominal skin: 36.0–36.5 °C −Inspired air temperature (hood, CPAP, or ventilator): 34.0–41.0 °C, relative humidity of 100%	[38,39]
Optimize early parenteral energy intake	−In the first postnatal week: 80–100 kcal/kg/day −After the first postnatal week: 120–150 kcal/kg/day	[44,78]
Optimize early parenteral amino acid intake	−Start with 1.5–2 g/kg/day after birth −Increase to 3.5 g/kg/day from the first 48–72 postnatal hours	[79]
Optimize early parenteral fat intake	−Start with 1.0–2.0 g/kg/day within the first postnatal day −Increase by 0.5–1.0 g/kg/day up to a maximum of 4.0 g/kg/day at 72–96 postnatal hours	[80]
Provide adequate intravenous glucose	−Limit the rate to 12 mg/kg/min (ideal limit: 8.3 mg/kg/min)	[33]
Optimize early parenteral calcium and phosphorus intake	−In the first postnatal week: parenteral Ca 32–80 mg/kg/day and P 31–62 mg/kg/day −After the first postnatal week: parenteral Ca 100–140 mg/kg/day and P 77–108 mg/kg/day −Parenteral Ca/P ratio: 1.3 (mass) or 1 (molar)	[86]
Provide adequate intravenous lipid soluble vitamins	−Vitamin A (retinol) 227–455 µg/kg/day or 700–1500 IU/kg/day −Vitamin E (α-tocopherol) 2.8–3.5 IU/kg/day	[90]
Provide adequate intravenous trace elements	−Particularly zinc 400–500 μg/kg/day	[91]
Initiate early enteral feeding	−Initiate minimal enteral feeding (12–24 mL/kg/day) prior to 3rd postnatal day −Use preferably mother’s own milk or donor human milk as second choice	[101,106,125]