Standardizing Neonatal Body Composition Assessment Using Air Displacement Plethysmography: Insights from the Bavarian Experience

Body composition is increasingly recognized as a key factor in neurodevelopment and long-term health in both preterm and term infants. Air Displacement Plethysmography (ADP), particularly the PEAPOD® system, has a strong track record in research and is gaining momentum in clinical settings. Building on previous experience, this study evaluated the safety and feasibility of ADP in preterm infants, reviewed existing clinical protocols, and implemented a standardized routine: the Bavarian Clinical Protocol (BCP).

A dual systematic literature review identified 76 studies reporting 8,317 infant assessments with no adverse events and highlighted three published clinical protocols. Following the introduction of the BCP at Nuremberg Children’s University Hospital, 626 of 702 eligible infants (89.1%) received ADP assessments, totaling 851 measurements, again with no adverse events and seamless integration into clinical workflows.

The BCP represents a significant advance in neonatal body composition assessment. It provides a robust, standardized framework for routine ADP use, strengthens scientific comparability, supports individualized nutrition strategies, and contributes to improved neonatal outcomes. ADP measurements are non-invasive and as safe as conventional anthropometric methods, while offering the additional advantage of precise body composition data. This enables tailored nutritional interventions based on body composition reference charts, ultimately enhancing the quality of neonatal care.