This education is about:

• The neonatal protein gap in preterm and medically complex infants receiving human milk
• The role of protein in lean body mass accrual and neurodevelopment in preterm infants
• Biologic variability in human milk composition by gestational age, stage of lactation, and other factors
• Metabolic consequences in medically complex infants
• Individualized fortification approaches for preterm infants
• Recognizing and addressing protein deficits in the NICU and PICU

Why it matters:

Optimizing protein delivery is critical to supporting growth, neurodevelopment, and recovery in preterm and medically complex infants. However, variability in human milk composition and reliance on standard fortification strategies can lead to unrecognized protein deficits and suboptimal outcomes. This activity addresses emerging evidence and practical strategies to help clinicians identify and close this clinically important “protein gap.”

What you will learn:

This activity explores the emerging concept of the “protein gap” in neonatal and pediatric critical care, highlighting how variability in human milk composition, including differences between mother’s own milk and donor human milk, can lead to unintended protein deficits despite seemingly adequate feeding plans. Faculty review current evidence supporting protein requirements for preterm infants, examine the clinical consequences of cumulative protein deficits, and discuss practical approaches to fortification and protein delivery in NICU and PICU settings. Through this discussion, participants gain clinically actionable strategies to better recognize protein shortfalls, individualize nutrition support, and align feeding practices with evolving guideline-based protein targets to improve growth, recovery, and developmental outcomes in high-risk infants.