scholarly journals A clinical audit of the growth of preterm infants fed predominantly pasteurised donor human milk v. those fed mother’s own milk in the neonatal intensive care unit

2019 ◽  
Vol 121 (09) ◽  
pp. 1018-1025 ◽  
Author(s):  
Megan L. Lloyd ◽  
Eva Malacova ◽  
Ben Hartmann ◽  
Karen Simmer
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Gestational Age ◽  
Growth Velocity ◽  
Neonatal Intensive Care ◽  
Clinical Audit ◽  
Donor Human Milk ◽  
Weight Growth ◽  
Significant Difference ◽  
Mother’S Own Milk

AbstractPreterm infants whose mothers are unable to produce sufficient breast milk are increasingly being supplemented with pasteurised donor human milk (PDHM) instead of commercial preterm infant formula. Concerns have been raised that this practice can result in reduced growth. This retrospective clinical audit collected data from the medical records of a cohort of preterm infants (≤30 weeks gestational age) receiving either ≥28 d of PDHM (n 53) or ≥28 d of their mother’s own milk (MOM, n 43) with standard fortification supplied to both groups during admission. Weight growth velocity was assessed from regained birth weight to 34+1 weeks’ postmenstrual age (PMA); and weight, length and head circumference were compared at discharge and 12 months (corrected age). At 34+1 weeks’ PMA, the weight growth velocity (g/kg per d) was significantly lower in the PDHM group (15·4 g/kg per d, 95 % CI 14·6, 16·1) compared with the MOM group (16·9 g/kg per d, 95 % CI 16·1, 17·7, P=0·007). However, the increase was still within clinically acceptable limits (>15 g/kg per d) and no significant difference was observed in the weight between the two groups. There was no significant difference in weight between the groups at discharge or at the 12-month corrected gestational age review. Although we demonstrated a significant reduction in the weight growth velocity of preterm infants receiving PDHM at 34 weeks’ PMA, this difference is not present at discharge, suggesting that the growth deficit is reduced by supplementation before discharge.

scholarly journals MACRONUTRIENTS OF MOTHERS’ MILK OF VERY LOW BIRTH WEIGHT INFANTS: ANALYSIS ACCORDING TO GESTATIONAL AGE AND MATERNAL VARIABLES

2021 ◽  
Vol 39 ◽  
Author(s):  
Maria Elisabeth Lopes Moreira ◽  
Sabrina Lopes Lucena ◽  
Patrícia Sffeir Coelho de Magalhães ◽  
Adriana Duarte Rocha ◽  
Ana Carolina Carioca Costa ◽  
...  
Keyword(s):  
Human Milk ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Newborn Infants ◽  
Infrared Analysis ◽  
Low Birth Weight Infants ◽  
Significant Difference ◽  
Maternal Hypertension ◽  
First Moment

ABSTRACT Objective: To analyze the composition of macronutrients present in the milk of mothers of preterm newborn infants (PTNB) - protein, fat, carbohydrate, and calories - by gestational age (GA), chronological age (CA) and maternal variables. Methods: Longitudinal study that analyzed 215 milk samples from the 51 mothers of PTNB admitted in three Neonatal Intensive Care Units of Rio de Janeiro from May/2013-January/2014. Milk collection was performed by pickup pump, on a fixed day of each week until discharge. The spectrophotometric technique with Infrared Analysis (MilkoScan Minor 104) was used for the quantitative analysis. A sample of 7 mL of human milk was taken from the total volume of milk extracted by the mother. The data was grouped by GA (25-27, 28-31, 32-36, 37-40 weeks) and by CA (zero to 4, 5-8, 9-12, 13-16 weeks). Results: Protein, carbohydrate, fat and calories did not show any pattern of change, with no difference among groups of GA. When the macronutrients were analyzed by groups of CA, protein decreased, with significant difference between the first two groups of CA. Carbohydrates, fat and calories presented increasing values in all groups, without significant differences. Weight gain during pregnancy, maternal hypertension and maternal age were associated with changes in fat and calories in the first moment of the analysis of milk. Conclusions: There was a significant decrease in the levels of protein during the first eight weeks after birth. CA may be an important factor in the composition of human milk.

scholarly journals Inoculation of mother’s own milk could personalize pasteurized donor human milk used for feeding preterm infants

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
D. Mallardi ◽  
C. Tabasso ◽  
P. Piemontese ◽  
S. Morandi ◽  
T. Silvetti ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Bacterial Growth ◽  
Microbiological Quality ◽  
In Vitro Study ◽  
Total Bacterial Count ◽  
Milk Samples ◽  
Donor Human Milk ◽  
Mother’S Own Milk

Abstract Background Human milk is a vehicle for bioactive compounds and beneficial bacteria which promote the establishment of a healthy gut microbiome of newborns, especially of preterm infants. Pasteurized donor human milk (PDHM) is the second-best option when preterm mother’s own milk is unavailable. Since pasteurization affect the microbiological quality of donor milk, PDHM was inoculated with different preterm milk samples and then incubated, in order to evaluate the effect in terms of bacterial growth, human milk microbiome and proteolytic phenomena. Methods In an in-vitro study PDHM was inoculated at 10% v/v using ten preterm milk samples. Microbiological, metataxonomic and peptidomic analyses, on preterm milk samples at the baseline (T0), on PDHM and on inoculated milk (IM) samples at T0, after 2 h (T1) and 4 h (T2) of incubation at 37 °C, were conducted. Results IM samples at T2 showed a Total Bacterial Count not significantly different (p > 0.01) compared to preterm milk samples. At T2 lactic acid bacteria level was restored in all IM. After inoculation, metataxonomic analysis in IM samples showed that Proteobacteria remained the predominant phylum while Firmicutes moved from 3% at T1 to 9.4% at T2. Peptidomic profile of IM resembled that of PDHM, incubated for the same time, in terms of number and type of peptides. Conclusion The study demonstrated that inoculation of PDHM with mother’s own milk could restore bacterial growth and personalize human milk microbiome in PDHM. This effect could be beneficial because of the presence of maternal probiotic bacteria which make PDHM more similar to mother’s own milk.

scholarly journals Inadequate Content of Docosahexaenoic Acid (DHA) of Donor Human Milk for Feeding Preterm Infants: A Comparison with Mother’s Own Milk at Different Stages of Lactation

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1300
Author(s):  
Félix Castillo ◽  
Félix-Joel Castillo-Ferrer ◽  
Begoña Cordobilla ◽  
Joan Carles Domingo
Keyword(s):  
Fatty Acids ◽  
Docosahexaenoic Acid ◽  
Human Milk ◽  
Linolenic Acid ◽  
Preterm Infants ◽  
High Dose ◽  
Mature Milk ◽  
Donor Human Milk ◽  
Milk Banking ◽  
Mother’S Own Milk

A cross-sectional single-center study was designed to compare the fatty acids profile, particularly docosahexaenoic acid (DHA) levels, between milk banking samples of donor human milk and mother’s own milk (MOM) for feeding preterm infants born before 32 weeks’ gestation. MOM samples from 118 mothers included colostrum (1–7 days after delivery), transitional milk (9–14 days), and mature milk (15–28 days and ≥29 days). In the n-3 polyunsaturated fatty acids (PUFAs) group, the levels of α-linolenic acid (C18:3 n3) and DHA (C22:6 n3) showed opposite trends, whereas α-linolenic acid was higher in donor human milk as compared with MOM, with increasing levels as stages of lactation progressed, DHA levels were significantly lower in donor human milk than in MOM samples, which, in turn, showed decreasing levels along stages of lactation. DHA levels in donor human milk were 53% lower than in colostrum. Therefore, in preterm infants born before 32 weeks’ gestation, the use of pasteurized donor human milk as exclusive feeding or combined with breastfeeding provides an inadequate supply of DHA. Nursing mothers should increase DHA intake through fish consumption or nutritional supplements with high-dose DHA while breastfeeding. Milk banking fortified with DHA would guarantee adequate DHA levels in donor human milk.

scholarly journals Inoculation of Mother’s Own Milk Could Personalize Microbiological, Metataxonomic and Peptidomic Profile of Pasteurized Donor Human Milk Used for Feeding Preterm Infants

2021 ◽  
Author(s):  
Domenica Mallardi ◽  
Chiara Tabasso ◽  
Pasqua Piemontese ◽  
Stefano Morandi ◽  
Tiziana Silvetti ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Bacterial Growth ◽  
Bacterial Count ◽  
Total Bacterial Count ◽  
Milk Samples ◽  
Donor Human Milk ◽  
Peptidomic Analysis ◽  
Mother’S Own Milk

Abstract Background Human milk is a vehicle of bioactive compounds and beneficial bacteria which promote the establishment of a healthy gut microbiome of newborns, especially of preterm infants. Pasteurized donor human milk (PDHM) is the second-best option when preterm mother’s own milk is unavailable. Since pasteurization affect the quality of donor milk, the effect on bacterial growth, human milk microbiota diversity and proteolytic phenomena in PDHM inoculated with different preterm milk samples, was evaluated. Methods Ten preterm milk samples was used to perform inoculation of PDHM at 10% v/v. Microbiological, metataxonomic and peptidomic analysis, on preterm milk samples at the baseline (T0) and PDHM and inoculated milk (IM) samples at T0, after 2h (T1) and 4h (T2) of incubation at 37°C, were conducted. Results IM samples at T2 showed a Total Bacterial Count not significantly different (p > 0.01) compared to preterm milk samples. Lactic acid bacteria (LAB) level was restored in all IM at T2. After inoculation, metataxonomic analysis showed that Proteobacteria remained the predominant phylum while Firmicutes moved from 3% at T1 to 9.4% at T2 in IM samples. Peptidomic profile of IM resembled that of PDHM incubated for the same time in terms of number and type of peptides. Conclusion The study demonstrated that inoculation with fresh mother’s own milk could restore bacterial growth and personalize human milk microbiome in PDHM. This effect could be beneficial thanks to the presence of maternal probiotic bacteria which make PDHM more similar to mother’s own milk.

scholarly journals Differential Effects of Mother's Own Milk, Donor Human Milk and Formula Feeding on the Fecal Microbiota of Preterm Infants During Their Stay in the Neonatal Intensive Care Unit (FS04-06-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Miriam Aguilar-Lopez ◽  
Chris Wetzel ◽  
Alissa MacDonald ◽  
Carey Gaede ◽  
Vitaliy Soloveychik ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Environmental Factors ◽  
Human Milk ◽  
Neonatal Intensive Care ◽  
Fecal Microbiota ◽  
Microbiome Composition ◽  
Donor Human Milk ◽  
Mother’S Own Milk ◽  
Over Time

Abstract Objectives Preterm infants (PTI) are at risk for many complications including growth retardation, and co-morbidities, such as necrotizing enterocolitis. Microbiome composition is influenced by diet and other environmental factors or medical treatments. The use of mother's own milk (MOM) or donor human milk (DHM) is recommended over preterm formula (PF). However, when there is insufficient human milk (HM), PF is used. The objective of this study was to evaluate how each type of feed (MOM, DHM and PF) affects PTI gut microbiota composition during the infant's Neonatal Intensive Care Unit (NICU) stay. Methods This cohort study followed PTI from birth until discharge from the NICU. Medical records, weekly weight and daily feed volume were recorded. Stool samples (n = 551) were collected from the infant's diaper. Total DNA was extracted to assess microbiome composition, V3-V4 regions of 16S rRNA gene were amplified and sequenced using Illumina HiSeq and data were analyzed in Qiime2. Results PTI (n = 97; 63% female) were enrolled with mean gestational age (GA) of 29 ± 2.45 weeks, birth weight of 1.27 ± 0.43 kg, and 78% delivered by C-section. Infants were discharged at 37 ± 2.06 weeks corrected GA (cGA) weighing 2.69 ± 0.57 kg. At birth, PTI from black mothers (27%) had higher (P < 0.05) microbiota diversity (observed OTUs) than other ethnicities. No differences in microbiota were found for sex or mode of delivery in the first 14d postpartum. PF was not fed prior to 34 weeks cGA. Over time, microbiota beta diversity differentiated by cGA and type of feeding. In HM-fed PTI, when > 50% MOM was consumed, the abundance of Clostridium, Enterococcus, and Staphylococcus was higher (P < 0.05) than DHM. When > 50% DHM was fed, Bifidobacteium, Paeniclostridium, Staphylococcus and Veillonela increased (P < 0.05) compared to > 50% MOM. In PTI fed both HM and PF, in those consuming > 33% PF, the abundance of Clostridium difficile was higher and Staphylococcuslower than either MOM or DHM (P < 0.05). Conclusions The development of fecal microbiota of PTI was modulated by cGA, such that abundance and diversity increased over time. The fecal microbiota was differently modified by consumption of human milk, either MOM or DHM, versus PF. Ongoing studies are investigating the effect of milk fortifiers and other NICU environmental factors on the gut microbiota. Funding Sources Supported by a seed grant from Carle Foundation Hospital and University of Illinois and a CONACyT Graduate Fellowship.

scholarly journals 100% human milk diet: an integral part of nutrition management in NICU: PAN India neonatologist’s survey

2021 ◽  
Vol 8 (3) ◽  
pp. 445
Author(s):  
Sanjay Wazir ◽  
Syed Ershad Mustafa ◽  
Vikram K. Reddy
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Online Survey ◽  
Bovine Milk ◽  
Biochemical Parameter ◽  
Milk Diet ◽  
Post Discharge ◽  
Donor Human Milk ◽  
Milk Banks

Background: Exclusive human milk diet (EHMD) benefits preterm infants the most, particularly in neonatal intensive care unit. EHMD is dependent on multiple factors consisting of breastfeeding awareness, availability of pasteurized donor human milk, functioning human milk banks and infrastructure. Neonatal nutritional practice varies considerably in India. The aim of this survey was to understand the implementation and benefits of 100% human milk diet through human milk derived nutritional products in preterm infants from NICU experts’ perspective.Methods: The online survey questionnaire formulated and reviewed by the expert neonatologists was shared with the NICU experts pan India through multiple communication channels and referrals. The survey was constructed on the Google Forms platform, the responses was collected between May 2020 to July 2020.Results: A total of 100 neonatologists responded to the survey from 79 hospitals and 31 cities across India. All the respondents (100%) opined that EHMD is important for preterm infants, 15% opined that EHMD was ensured to all preterm infants, 80% opined that human milk-based fortifier (HMBF) was safe and well tolerated by premature infants, 17% reported that 51-80% of preterm infants experience feed intolerance issues with bovine milk based fortifiers (BMBF), blood urea nitrogen (49%) was chosen as an optimal biochemical parameter for assessing protein utilization in NICU, 93% opined that post discharge nutritional supplementation is required for preterm infants among which 49% respondents opined that HMBF and human milk 70 calorie sachet would be preferable as post discharge nutritional supplementation.Conclusions: EHMD unequivocally offers multiple benefits to preterm infants and hence needs to be included in the NICU protocol, availability of human milk derived nutritional products such as HMBF are termed safe and well tolerated and would aid in implementing EHMD in NICUs. Pasteurized donor human milk is vital for ensuring EHMD, thus access to the same needs to be empowered by strengthening the human milk donation and awareness measures.

scholarly journals Packed Cell Transfusion and Feeding Tolerance in Healthy Preterm Infants: A Randomized Clinical Tria

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Minoo Fallahi ◽  
Mohammad Kazemian ◽  
Saeed Hojat Kashani ◽  
Saleheh Tajalli ◽  
Naeeme Taslimi
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Preterm Neonates ◽  
Control Group ◽  
Significant Difference ◽  
Packed Cell Transfusion ◽  
Feeding Tolerance

Background: Recently, the correlation between necrotizing enterocolitis (NEC) and packed cell transfusion (PCT) has been identified. Evidence shows that 25 - 35% of NEC cases are associated with PCT. Objectives: this study aimed to determine the association between PCT and feeding tolerance in healthy preterm newborns. Methods: Materials and Methods: This clinical trial was performed on preterm infants, admitted to the neonatal intensive care unit (NICU) of Mofid Children's Hospital, Tehran, Iran, from April 2017 to May 2018. A total of 70 healthy premature infants (birth weight < 1500 g and gestational age < 32 weeks) with enteral feeding, who required PCT, were included in this study. The eligible infants were divided into two groups by simple randomization. In the intervention group (n = 35), breastfeeding was withheld only during PCT and then continued as usual. On the other hand, in the control group (n = 35), feeding was performed as usual, regardless of PCT. Feeding tolerance within the first 72 hours post-transfusion was compared between the two groups. Sick newborns were excluded from the study. Data analysis was performed in SPSS version 20. Results: The mean gestational age, birth weight, and postnatal age of the neonates were 30.13 weeks, 1245.71 g, and 17 days in the intervention group and 29.97 weeks, 1169.43 g, and 15.46 days in the control group, respectively; there was no significant difference between the two groups. Except for pre-transfusion hemoglobin and hematocrit levels, other characteristics of the two groups were similar. Feeding tolerance was reported in 32 (91.2%), 33 (94.73%), and 34 (97.1%) newborns at 24, 48, and 72 hours post-transfusion in both groups, without any significant difference. There was no significant difference between neonates with and without feeding tolerance in either of the groups. Conclusions: According to the present results, withholding feeding during PCT is not necessary in healthy preterm neonates with a good general condition, and continued breastfeeding seems to be a safe option.

scholarly journals Frozen Mother’s Own Milk Can Be Used Effectively to Personalize Donor Human Milk

2021 ◽  
Vol 12 ◽  
Author(s):  
Monica F. Torrez Lamberti ◽  
Natalie A. Harrison ◽  
Marion M. Bendixen ◽  
Evon M. DeBose-Scarlett ◽  
Sharon C. Thompson ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Alpha Diversity ◽  
Innate Immune ◽  
Beneficial Bacteria ◽  
Microbial Composition ◽  
Fresh Sample ◽  
Donor Human Milk ◽  
Culture Independent ◽  
Mother’S Own Milk

Feeding preterm infants mother’s own milk (MOM) lowers rates of sepsis, decreases necrotizing enterocolitis, and shortens hospital stay. In the absence of freshly expressed MOM, frozen MOM (FMOM) is provided. When MOM is unavailable, preterm infants are often fed pasteurized donor human milk (DHM), rendering it devoid of beneficial bacteria. We have previously reported that when MOM is inoculated into DHM to restore the live microbiota [restored milk (RM)], a similar microbial diversity to MOM can be achieved. Yet, it is unknown if a similar diversity to MOM can be obtained when FMOM is inoculated into DHM. The goal of this study was to determine whether a similar microbial composition to MOM could be obtained when FMOM is used to personalize DHM. To this end, a fresh sample of MOM was obtained and divided into fresh and frozen fractions. MOM and FMOM were inoculated into DHM at different dilutions: MOM/FMOM 10% (RM/FRM10) and MOM/FMOM 30% (RM/FRM30) and incubated at 37°C. At different timepoints, culture-dependent and culture-independent techniques were performed. Similar microbiota expansion and alpha diversity were observed in MOM, RM10, and RM30 whether fresh or frozen milk was used as the inoculum. To evaluate if microbial expansion would result in an abnormal activation on the innate immune system, Caco-2 epithelial cells were exposed to RM/FRM to compare interleukin 8 levels with Caco-2 cells exposed to MOM or DHM. It was found that RM samples did not elicit a significant increase in IL-8 levels when compared to MOM or FMOM. These results suggest that FMOM can be used to inoculate DHM if fresh MOM is unavailable or limited in supply, allowing both fresh MOM and FMOM to be viable options in a microbial restoration strategy.

scholarly journals Regional variation in cost of neonatal intensive care for extremely preterm infants

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Asaph Rolnitsky ◽  
David Urbach ◽  
Sharon Unger ◽  
Chaim M. Bell
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Preterm Infants ◽  
Gestational Age ◽  
Regional Variation ◽  
Neonatal Intensive Care ◽  
Cost Optimization ◽  
Program Cost ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract Background Regional variation in cost of neonatal intensive care for extremely preterm infant is not documented. We sought to evaluate regional variation that may lead to benchmarking and cost saving. Methods An analysis of a Canadian national costing data from the payor perspective. We included all liveborn 23–28-week preterm infants in 2011–2015. We calculated variation in costs between provinces using non-parametric tests and a generalized linear model to evaluate cost variation after adjustment for gestational age, survival, and length of stay. Results We analysed 6932 infant records. The median total cost for all infants was $66,668 (Inter-Quartile Range (IQR): $4920–$125,551). Medians for the regions varied more than two-fold and ranged from $48,144 in Ontario to $122,526 in Saskatchewan. Median cost for infants who survived the first 3 days of life was $91,000 (IQR: $56,500–$188,757). Median daily cost for all infants was $1940 (IQR: $1518–$2619). Regional variation was significant after adjusting for survival more than 3 days, length of stay, gestational age, and year (pseudo-R2 = 0.9, p < 0.01). Applying the model on the second lowest-cost region to the rest of the regions resulted in a total savings of $71,768,361(95%CI: $65,527,634–$81,129,451) over the 5-year period ($14,353,672 annually), or over 11% savings for the total program cost of $643,837,303 over the study period. Conclusion Costs of neonatal intensive care are high. There is large regional variation that persists after adjustment for length of stay and survival. Our results can be used for benchmarking and as a target for focused cost optimization, savings, and investment in healthcare.

scholarly journals Impact of size at birth and postnatal growth on metabolic and neurocognitive outcomes in prematurely born school-age children

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoo Jinie Kim ◽  
Seung Han Shin ◽  
Eun Sun Lee ◽  
Young Hwa Jung ◽  
Young Ah Lee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Growth Velocity ◽  
Postnatal Growth ◽  
School Age ◽  
Z Score ◽  
Neurodevelopmental Outcomes ◽  
Neurocognitive Outcomes ◽  
Size At Birth

AbstractPrematurity, size at birth, and postnatal growth are important factors that determine cardiometabolic and neurodevelopmental outcomes later in life. In the present study, we aimed to investigate the associations between the size at birth and growth velocity after birth with cardiometabolic and neurodevelopmental outcomes in preterm infants. Fifty-six preterm infants born at < 32 weeks of gestation or having a birth weight of < 1500 g were enrolled and categorized into small for gestational age (SGA) and appropriate for gestational age (AGA) groups. Anthropometric and cardiometabolic parameters were assessed at school-age, and the Korean Wechsler Intelligence Scale for Children, fourth edition (K-WISC-IV) was used for assessing the intellectual abilities. The growth velocity was calculated by changes in the weight z-score at each time period. Multivariate analysis was conducted to investigate the associations of growth velocity at different periods with cardiometabolic and neurodevelopmental outcomes. Forty-two (75%) were classified as AGA and 25% as SGA. At school-age, despite the SGA children showing significantly lower body weight, lean mass index, and body mass index, there were no differences in the cardiometabolic parameters between SGA and AGA groups. After adjusting for gestational age, birth weight z-score, weight z-score change from birth to discharge and sex, change in weight z-score beyond 12 months were associated with a higher systolic blood pressure, waist circumference, and insulin resistance. Full-scale intelligent quotient (β = 0.314, p = 0.036) and perceptional reasoning index (β = 0.456, p = 0.003) of K-WISC-IV were positively correlated with postnatal weight gain in the neonatal intensive care unit. Although cardiometabolic outcomes were comparable in preterm SGA and AGA infants, the growth velocity at different time periods resulted in different cardiometabolic and neurocognitive outcomes. Thus, ensuring an optimal growth velocity at early neonatal period could promote good neurocognitive outcomes, while adequate growth after 1 year could prevent adverse cardiometabolic outcomes in preterm infants.

Sign in / Sign up

Export Citation Format

Share Document