scholarly journals Adiposity and Fat-Free Mass of Children Born with Very Low Birth Weight Do Not Differ in Children Fed Supplemental Donor Milk Compared with Those Fed Preterm Formula

2019 ◽  
Author(s):  
Meghan McGee ◽  
Sharon Unger ◽  
Jill Hamilton ◽  
Catherine S Birken ◽  
Zdenka Pausova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Composition ◽  
Birth Weight ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Donor Milk ◽  
Preterm Formula ◽  
Mother's Milk ◽  
Mother’S Milk

ABSTRACT Background Many mothers of very-low-birth-weight (VLBW) infants (<1500 g) are unable to provide sufficient breast milk, and supplemental pasteurized donor human milk (donor milk) or preterm formula is required. The composition of donor milk differs from that of mother's milk and infants fed with donor milk often exhibit slower growth during hospitalization. The long-term impact of nutrient-enriched donor milk on growth, body composition, or blood pressure is unknown. Objective We aimed to determine the effects of nutrient-enriched donor milk compared with preterm formula on growth, body composition, and blood pressure of children born preterm and with VLBW. Associations with in-hospital mother's milk intake were explored. Methods This study was a follow-up of children at 5.5-y of age who participated in a randomized controlled trial evaluating the effect of nutrient-enriched donor milk (commencing at ≥120 mL·kg−1·d−1) or preterm formula fed as a supplement when mother's milk was unavailable. The trial intervention lasted 90 d or until hospital discharge, whichever occurred first. In this follow-up investigation, differences in total body fat percentage determined by using air displacement plethysmography (primary outcome), fat-free mass, skinfold thickness, waist circumference, BMI z scores, and blood pressure] were evaluated using linear regressions. Results Of 316 surviving infants from the earlier trial, 158 (50%) participated in the current study (53% male). Mean ± SD birth weight and gestational age were 1013 ± 264 g and 27.9 ± 2.5 wk. The median (IQR) intervention period was 67.5 d (52.0–91.0 d). Mean ± SD age and BMI z score at follow-up were 5.7 ± 0.2 y and −0.3 ± 1.2. Supplemental nutrient-enriched donor milk, compared to preterm formula, was not associated with growth, body composition, or blood pressure. In-hospital mother's milk intake was positively associated with height z score at 5.5 y (β: 0.07; 95% CI: 0.004, 0.1; P = 0.04). Conclusions Supplemental nutrient-enriched donor milk and preterm formula during initial hospitalization results in comparable long-term growth and body composition in young children born VLBW. This trial was registered at clinicaltrials.gov as NCT02759809 and at isrctn.com as ISRCTN35317141,

scholarly journals Associations between Diet Quality and Body Composition in Young Children Born with Very Low Body Weight

2020 ◽  
Vol 150 (11) ◽  
pp. 2961-2968
Author(s):  
Meghan McGee ◽  
Sharon Unger ◽  
Jill Hamilton ◽  
Catherine S Birken ◽  
Zdenka Pausova ◽  
...  
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Diet Quality ◽  
Healthy Eating Index ◽  
Neurodevelopmental Outcomes ◽  
Donor Milk ◽  
Added Sugars ◽  
Air Displacement Plethysmography ◽  
Z Scores

ABSTRACT Background Very low birth weight (VLBW; &lt;1500 g) infants have increased adiposity and metabolic disease risk in adulthood. Limited evidence suggests low-quality childhood diets are a predisposing risk factor. Despite this, to our knowledge no study has yet examined associations between diet quality and body composition in VLBW individuals. Objective The objective of this study was to determine associations between Healthy Eating Index-2010 (HEI-2010) scores and consumption of fruits/vegetables, added sugars, and macronutrients with body composition in 5.5-y-old children born VLBW. We hypothesized HEI-2010 scores were inversely associated with adiposity. Methods This cohort study leveraged the 5.5-y follow-up to the Donor Milk for Improved Neurodevelopmental Outcomes randomized controlled trial. From June 2016 to July 2018, participants attended a follow-up visit at The Hospital for Sick Children, Canada, or were visited in their home. All 316 surviving infants from the trial were eligible, and the caregivers of 158 children (50%; 53% male) consented to follow-up. Diet quality (HEI-2010) and usual intake of fruits/vegetables, added sugars, and macronutrients were determined from two 24-h dietary recalls (ASA24). Linear regressions evaluated associations of diet with BMI (kg/m2) and waist circumference z-scores, total fat, fat-free mass (air displacement plethysmography), and skinfolds. Results Mean ± SD age at follow-up was 5.7 ± 0.2 y, birth weight was 1013 ± 264 g, and gestational age was 27.9 ± 2.5 wk. Dietary data and BMI z-scores were available for all children; 123 completed air displacement plethysmography. HEI-2010 score was 58.2 ± 12.4 out of 100, and 27% of children had poor quality diets (scores ≤50). HEI-2010 scores were inversely associated with BMI z-score, but only in children with obese mothers. A 10-point increase in HEI-2010 score was associated with reduced BMI (β: −0.5 SD; 95% CI: −0.7, −0.2) and subscapular (−0.3 SD; 95% CI: −0.6, −0.06) z-scores. Conclusions Improving diet quality in children born VLBW with obese mothers may be an important strategy to prevent excess adiposity. This trial was registered at clinicaltrials.gov as Optimizing Mothers' Milk for Preterm Infants (OptiMoM) Program of Research: Study 1-Impact of Donor Milk at Kindergarten, NCT02759809.

Very Low Birth Weight Infants Born to Cytomegalovirus-Seropositive Mothers Fed with Their Mother's Milk: A Prospective Study

2009 ◽  
Vol 154 (6) ◽  
pp. 842-848 ◽  
Author(s):  
Maria Grazia Capretti ◽  
Marcello Lanari ◽  
Tiziana Lazzarotto ◽  
Liliana Gabrielli ◽  
Sara Pignatelli ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Prospective Study ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Mother's Milk ◽  
Mother’S Milk ◽  
A Prospective Study

Neurodevelopmental Outcome in Very Low Birth Weight Infants Exposed to Donor Milk

2021 ◽  
Author(s):  
Kousiki Patra ◽  
Michelle M. Greene ◽  
Grace Tobin ◽  
Gina Casini ◽  
Anita L. Esquerra-Zwiers ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Neurodevelopmental Outcome ◽  
Regression Analyses ◽  
Low Birth Weight Infants ◽  
Donor Milk ◽  
Preterm Formula ◽  
Before And After ◽  
The Impact

Objective This study was aimed to evaluate the impact of donor milk (DM) received in the first 28 days of life (DOL) on neurodevelopmental (ND) outcome at 20-month corrected age (CA) in very low birth weight (VLBW) infants. Study Design A total of 84 infants born in 2011 to 2012 who received only mother's own milk (MOM) and/or preterm formula (PF) was compared with 69 infants born in 2013 to 2014 who received MOM and/or DM. Daily enteral intake of MOM, DM, and PF was collected through 28 DOL. ND outcomes were assessed with the Bayley-III. Multiple regression analyses were adjusted for the effect of social and neonatal risk factors, alongside era of birth on ND outcome. Results Infants exposed to DM were born to older mothers (p < 0.01) and had higher incidence of severe brain injury (p = 0.013). Although DM group infants received first feed at earlier DOL (p < 0.001), there were no differences in MOM intake at DOL 14 or 28 between the two groups. In regression analyses, DM group did not predict 20-month ND outcome. Conclusion There were no differences in ND outcome between infants born before and after the introduction of DM. This may have been due to the similar percent of MOM at DOL 14 and 28 in the two eras. Key Points

scholarly journals Targeted Breast Milk Fortification for Very Low Birth Weight (VLBW) Infants: Nutritional Intake, Growth Outcome and Body Composition

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1156 ◽  
Author(s):  
Sumesh Parat ◽  
Praneeta Raza ◽  
May Kamleh ◽  
Dennis Super ◽  
Sharon Groh-Wargo
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Breast Milk ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Protein Intake ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Standard Group ◽  
Low Birth Weight Infants

Despite improvements in nutritional management, preterm infants continue to face high rates of postnatal growth restriction. Because variability in breast milk composition may result in protein and energy deficits, targeted fortification has been advocated. We conducted an interventional study to compare body composition and growth outcomes of very low birth weight infants fed targeted protein-fortified human milk (HM) with those fed standard fortified HM. If mother’s own milk was not available, donor milk was used. Weekly analysis of HM with mid-infrared spectroscopy was conducted and additional protein was added to the fortified HM to ensure a protein intake of 4 g/kg/day. Weekly anthropometric measurements were done. Prior to discharge or at 37 weeks, corrected age skinfold thickness (SFT) measurements as well as body composition measurement using air displacement plethysmography were done. Among 36 preterm infants enrolled, those in the targeted group (n = 17) received more protein and had a larger flank SFT at study end than those in the standard group (n = 19). A pilot post-hoc analysis of subjects having at least 30 intervention days showed a 3% higher fat-free mass in the targeted group. Use of a targeted fortification strategy resulted in a higher protein intake and fat-free mass among those receiving longer intervention.

scholarly journals Intake of Own Mother’s Milk during the First Days of Life Is Associated with Decreased Morbidity and Mortality in Very Low Birth Weight Infants during the First 60 Days of Life

Neonatology ◽  
2012 ◽  
Vol 102 (4) ◽  
pp. 276-281 ◽  
Author(s):  
Willemijn E. Corpeleijn ◽  
Stefanie M.P. Kouwenhoven ◽  
Muirne C. Paap ◽  
Ineke van Vliet ◽  
Irene Scheerder ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Morbidity And Mortality ◽  
Low Birth Weight Infants ◽  
Mother's Milk ◽  
Mother’S Milk

scholarly journals Energy Expenditure, Protein Oxidation and Body Composition in a Cohort of Very Low Birth Weight Infants

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3962
Author(s):  
Michela Perrone ◽  
Camilla Menis ◽  
Pasqua Piemontese ◽  
Chiara Tabasso ◽  
Domenica Mallardi ◽  
...  
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Energy Expenditure ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Protein Oxidation ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Low Birth Weight Infants

The nutritional management of preterm infants is a critical point of care, especially because of the increased risk of developing extrauterine growth restriction (EUGR), which is associated with worsened health outcomes. Energy requirements in preterm infants are simply estimated, so the measurement of resting energy expenditure (REE) should be a key point in the nutritional evaluation of preterm infants. Although predictive formulae are available, it is well known that they are imprecise. The aim of our study was the evaluation of REE and protein oxidation (Ox) in very low birth weight infants (VLBWI) and the association with the mode of feeding and with body composition at term corrected age. Methods: Indirect calorimetry and body composition were performed at term corrected age in stable very low birth weight infants. Urinary nitrogen was measured in spot urine samples to calculate Ox. Infants were categorized as prevalent human milk (HMF) or prevalent formula diet (PFF). Results: Fifty VLBWI (HMF: 23, PFF: 27) were evaluated at 36.48 ± 0.85 post-conceptional weeks. No significant differences were found in basic characteristics or nutritional intake in the groups at birth and at the assessment. No differences were found in the REE of HMF vs. PFF (59.69 ± 9.8 kcal/kg/day vs. 59.27 ± 13.15 kcal/kg/day, respectively). We found statistical differences in the protein-Ox of HMF vs. PFF (1.7 ± 0.92 g/kg/day vs. 2.8 ± 1.65 g/kg/day, respectively, p < 0.01), and HMF infants had a higher fat-free mass (kg) than PFF infants (2.05 ± 0.26 kg vs. 1.82 ± 0.35 kg, respectively, p < 0.01), measured with air displacement plethysmography. Conclusion: REE is similar in infants with a prevalent human milk diet and in infants fed with formula. The HMF infants showed a lower oxidation rate of proteins for energy purposes and a better quality of growth. A greater amount of protein in HMF is probably used for anabolism and fat-free mass deposition. Further studies are needed to confirm our hypothesis.

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