Early caloric deprivation in preterm infants affects Bayley-III scales performance at 18-24 months of corrected age.
Very preterm babies who miss early calories lag on Bayley-III scores at toddler age.
01Research in Context
What this study did
Doctors tracked extremely preterm babies in the NICU. They compared kids who got less than 85 calories per kilogram each day during the first two weeks with kids who got enough.
At 18–24 months corrected age, both groups took the Bayley-III. The team wanted to see if early calories shaped later thinking and moving scores.
What they found
The under-fed group scored lower on every Bayley-III area—cognitive, language, and motor. Less food early on meant lower numbers later.
The gap stayed even after doctors fixed the feeding problems. Early shortfall left a lasting mark.
How this fits with other research
Camargos et al. (2016) seems to say the opposite: heavy babies also score lower on the same test. Both studies show Bayley-III drops, but one group ate too little and the other too much. The shared lesson is that any early nutrition extreme can slow development.
McGlade et al. (2023) pooled trials of very early ABA-style programs for at-risk infants and found no clear gain on Bayley scores. Their review included preterm babies, so the calorie effect Mas et al. (2019) found might explain why some infants in those trials failed to budge—hunger can hide intervention benefit.
Szempruch et al. (1993) showed that adding calories to kids with cystic fibrosis lifted both weight and skills. Together the papers form a straight line: not enough calories early hurts development, and adding them can help.
Why it matters
If you assess a toddler born very early, always ask about the first two weeks of NICU intake. A history of low calories flags risk for ongoing delay even before you test. Share the Bayley-III numbers with the dietitian and medical team so feeding plans and early-intervention goals match.
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02At a glance
03Original abstract
BACKGROUND: Adequate nutrition is essential for optimal neurodevelopment to preterm infants. Our aim was to evaluate the impact of caloric deprivation on Bayley-III scales performance at 18-24 months of corrected age, in a cohort of preterm infants. METHODS: We prospectively enrolled infants with gestational age <30 weeks and birth weight <1500 g. Apart from a whole cohort analysis, we performed a subgroup analysis between infants received inadequate calories (<85 Kcal/kg/day) during the first two weeks of age, compared to a standard nutrition group. All infants underwent a Bayley-III assessment at 18-24 months of corrected age. RESULTS: From the 63 preterm infants analysed, 25% had caloric deprivation compared to 75% with adequate nutrition. Caloric deprived infants were of lower gestational age and birth weight, and received a lower amount of enteral feeding during the first 14 days of age. There were no differences between the two groups regarding the common neonatal co-morbidities. Caloric deprived infants had significantly lower composite index scores at 18-24 months of corrected age. Caloric deprivation, late onset sepsis, necrotizing enterocolitis, and bronchopulmonary dysplasia were significant risk factors of neurodevelopmental impairment. CONCLUSIONS: Several neonatal factors affect the neurodevelopmental outcome of preterm infants, and nutrition may pose an important role.
Research in developmental disabilities, 2019 · doi:10.1016/j.ridd.2019.103429