Comparison of the Results of Premature Babies Started Complementary Feeding in Adjusted or Chronologically in Their Sixth Month
Conditions: Premature Birth, Feeding Behavior
Sponsor: Hacettepe University

COMPARİSON OF THE 
RESULTS OF PREMATURE 
BABİES STARTED 
COMPLEMENTARY 
FEEDİNG İN ADJUSTED OR 
CHRONOLOGİCALLY İN 
THEİR SİXTH MONTH 
Documented Date: June,2 2020 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
Comparison of the Results of Premature Babies Started Complementary Feeding in 
Adjusted or Chronologically in their Sixth Month 
Study Protocol: 
Neurological-developmental evaluations and developmental outcomes-diagnoses of premature 
babies are evaluated according to corrected postnatal age. Based on the limited evidence 
available, it can be concluded that complementary feeding may be an appropriate age for most 
premature babies who have reached at least the third month, generally corrected. However, for 
premature babies born at different gestational weeks, these periods have a relatively different 
meaning. A more accurate timeframe can be found in terms of complementary nutrition by 
evaluating chronological age and motor development together. More prospective observational 
studies are needed in this regard in premature babies. In the literature, there are not enough 
studies on the transition time to the most appropriate complementary diet for premature babies. 
We planned to do this prospective observational study. 
Inclusion criteria for the study: 
• Male / female babies who were born before the mother at the Hacettepe University Children's 
Hospital Neonatal Intensive Care Unit and / or Hacettepe University Adult Hospital Maternity 
and Birth Service and were born earlier than 37 weeks. 
• Babies who are at the Hacettepe University Children's Hospital Neonatal Intensive Care Unit 
and / or Hacettepe University Adult Hospital Maternity and Maternity Service, were born earlier 
than 37 weeks and continue to be followed regularly in the neonatal outpatient clinic. 
• Babies whose informed consent was obtained for their participation by the family. 
 

Exclusion criteria: 
Babies with SGA (birth weight below 10th percentile according to gestational week) by birth 
weight 
• Babies with chromosomal anomalies 
• Babies diagnosed with hypoxic ischemic encephalopathy 
Babies who have had major surgical operations (gastrointestinal anomaly, severe necrotizing 
enterocolitis requiring surgery, major gastrointestinal system anomaly, major congenital heart 
anomaly, diaphragmatic hernia) 
• Babies with exitus in the neonatal period 
• Babies who do not continue regular polyclinic follow-up after discharge 
• Babies of families who do not comply with the study protocol 
• Babies with missing study data 
Families who accept their babies to participate in our study will be trained with a booklet, 
according to the recommendations of the World Health Organization, containing the standard 
supplementary nutritional information we prepared beforehand. 
 
 In this study, patient groups will be randomly selected after appropriate matching. Premature 
babies participating in the study will be handled in three main groups (six subgroups in total).  
Group 1: 29 weeks and six days of gestation and earlier 
Group 2: Those whose gestational age is between 30 weeks and 33 weeks and sixth days 
Group 3: Those whose gestational age is between 34 weeks and 37 weeks and sixth day 

Each main group will be divided into two subgroups, according to the time to start 
complementary feeding (corrected sixth month or chronologically sixth month): 
Group 1: 29 weeks and six days of gestation and earlier 
Group 1a: complementary feeding began chronologically in the sixth month 
Group 1b: Complementary feeding corrected at sixth month 
Group 2: Those whose gestational age is between 30 weeks and 33 weeks and sixth days 
Group 2a: complementary feeding began chronologically in the sixth month 
Group 2b: complementary feeding started in the sixth month, corrected 
Group 3: Those whose gestational age is between 34 weeks and 37 weeks and sixth day 
Group 3a: complementary feeding began chronologically in the sixth month 
Group 3b: complementary feeding started in the sixth month, corrected 
Before the transition to complementary nutrition of the groups included in the study, breast milk 
and / or formula food, nutritional supplement (such as breast milk enhancer, protein 
supplement) intake will be recorded. The same polyvitamin preparation will be used for all 
premature babies. In accordance with the recommendation of the World Health Organization, 
2 mg / kg / day standard oral iron prophylaxis will be started to all premature babies starting 
from the second chronological month. Immunization will be done in accordance with the 
national vaccination program. 
The data will be added to the case report forms. In addition to routine follow-ups, families will 
be called on the phone monthly, information about their babies' nutrition will be asked, whether 
there is a problem, questions of families will be answered, and information about 

complementary nutrition will be provided. At the end of the study, all data will be collected and 
entered into the SPSS database, which will be created.