Discussion
VLBW
GROWTH FAILURE, COMPLICATION
Preterm infants need to achieve their optimal growth rate, similar to intrauterine growth [12,18]. This aim is seldom achieved, and suboptimal postnatal growth still remains a significant complication in the VLBW infants. Moreover, there is a significant association between postnatal growth failure and adverse neurodevelopmental outcomes [5,6]. The present RCT trial evaluated the effect of extra protein supplement on the postnatal growth, and we compared the conventional protein intake (3.5 to less than 4 g/kg/day) with high protein intake (4–4.8 g/kg/day). The results showed that only 16.7% of the neonates in the control group and 19.4% of them in the protein supplement group were SGA, but the incidence of postnatal growth failure was increased during NICU admission (75% and 61.1% in the control and protein supplement groups, respectively). The incidence of PNGF in our control group was approximately similar to those reported by NICHD [Our study had some limitations such as a lack of long-term follow-up of our patients and the small sample size. However, based on group matchings and insignificant differences between the baseline features of our groups, we believe that our study could provide insight into further multicentral RCTs and review of articles to obtain the most satisfactory treatment and supplement regimen for neonates.