Development of a human milk concentrate with human milk lyophilizate for feeding very low birth weight preterm infants: A preclinical experimental study

Improvements in quality of care have led to a significant reduction in mortality and morbidity in preterm infants, especially very-low-birth-weight (VLBW) infants [...]

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Growth and nutrient intake among very-low-birth-weight infants fed fortified human milk during hospitalisation

British Journal Of Nutrition ◽

10.1017/s0007114509371755 ◽

2009 ◽

Vol 102 (8) ◽

pp. 1179-1186 ◽

Cited By ~ 55

Author(s):

Christine Henriksen ◽

Ane C. Westerberg ◽

Arild Rønnestad ◽

Britt Nakstad ◽

Marit B. Veierød ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Nutrient Intake ◽

Very Low Birth Weight ◽

Growth Restriction ◽

Vlbw Infants ◽

Uterine Growth ◽

Discharge From Hospital

Postnatal growth failure in preterm infants is due to interactions between genetic and environmental factors, which are not fully understood. We assessed dietary supply of nutrients in very-low-birth-weight (VLBW, < 1500 g) infants fed fortified human milk, and examined the association between nutrient intake, medical factors and growth during hospitalisation lasting on average 70 d. We studied 127 VLBW infants during the early neonatal period. Data were obtained from medical records on nutrient intake, growth and growth-related factors. Extra-uterine growth restriction was defined as body weight < 10th percentile of the predicted value at discharge. Using logistic regression, we evaluated nutrient intake and other relevant factors associated with extra-uterine growth restriction in the subgroup of VLBW infants with adequate weight for gestational age at birth. The proportion of growth restriction was 33 % at birth and increased to 58 % at discharge from hospital. Recommended values for energy intake (>500 kJ/kg per d) and intra-uterine growth rate (15 g/kg per d) were not met, neither in the period from birth to 28 weeks post-conceptional age (PCA), nor from 37 weeks PCA to discharge. Factors negatively associated with growth restriction were energy intake (Ptrend = 0·002), non-Caucasian ethnicity (P = 0·04) and weight/predicted birth weight at birth (Ptrend = 0·004). Extra-uterine growth restriction is common in VLBW infants fed primarily fortified human milk. Currently recommended energy and nutrient intake for growing preterm infants was not achieved. Reduced energy supply and non-Caucasian ethnicity were risk factors for growth restriction at discharge from hospital.

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Protein use and weight-gain quality in very-low-birth-weight preterm infants fed human milk or formula

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqx001 ◽

2018 ◽

Vol 107 (2) ◽

pp. 195-200 ◽

Cited By ~ 8

Author(s):

Laura Morlacchi ◽

Paola Roggero ◽

Maria Lorella Giannì ◽

Beatrice Bracco ◽

Debora Porri ◽

...

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Very Low Birth Weight

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Effect of targeted vs standard fortification of breast milk on growth and development of preterm infants (≤ 32 weeks): study protocol for a randomized controlled trial

Trials ◽

10.1186/s13063-020-04841-x ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Joanna Seliga-Siwecka ◽

Anna Chmielewska ◽

Katarzyna Jasińska

Keyword(s):

Randomized Controlled Trial ◽

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Very Low Birth Weight ◽

Controlled Trial ◽

Low Birth Weight Infants ◽

Randomized Controlled ◽

Link Type

Abstract Background Human milk is recommended for all very low birth weight infants. Breastmilk is highly variable in nutrient content, failing to meet the nutritional demands of this group. Fortification of human milk is recommended to prevent extrauterine growth retardation and associated poor neurodevelopmental outcome. However, standard fortification with fixed dose multicomponent fortifier does not account for the variability in milk composition. Targeted fortification is a promising alternative and needs further investigation. Methods This randomized controlled trial will recruit preterm infants (≤ 32 weeks of gestation) within the first 7 days of life. After reaching 80 ml/kg/day of enteral feeding, patients will be randomized to receive standard fortification (HMF, Nutricia) or targeted fortification (modular components: Bebilon Bialka, Nutricia—protein; Polycal, Nutricia—carbohydrates; Calogen, Nutricia—lipids). The intervention will continue until 37 weeks of post-conception age or hospital discharge. Parents and outcome assessors will be blinded to the intervention. The primary outcome measure is velocity of weight, length, and head growth until 36 weeks post-conceptional age or discharge. Secondary outcomes include neurodevelopment at 12 months assessed with Bayley Scale of Development III, repeated at 36 months; body composition at discharge and at 4 months; and incidence of necrotizing enterocolitis, sepsis, retinopathy of prematurity, and bronchopulmonary dysplasia. Discussion Targeted fortification has previously been shown as doable in the neonatal intensive care unit context. If it shows to improve growth and neonatal outcome, choosing the targeted fortification as a first line nutritional approach in very low birth weight infants may become a recommendation. Trial registration ClinicalTrials.govNCT03775785, Registered on July 2019.

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Probiotics Prevent Late-Onset Sepsis in Human Milk-Fed, Very Low Birth Weight Preterm Infants: Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu9080904 ◽

2017 ◽

Vol 9 (8) ◽

pp. 904 ◽

Cited By ~ 31

Author(s):

Arianna Aceti ◽

Luca Maggio ◽

Isadora Beghetti ◽

Davide Gori ◽

Giovanni Barone ◽

...

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Very Low Birth Weight ◽

Late Onset ◽

Meta Analysis ◽

Late Onset Sepsis

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Comparison of Very Low Birth Weight Preterm Infants with And Without Experienced Target Weight Gain on The Administration of Human Milk Fortifier

Journal of Biomedicine and Translational Research ◽

10.14710/jbtr.v6i3.9061 ◽

2020 ◽

Vol 6 (3) ◽

pp. 79-85

Author(s):

Diondra Eka Rizkiawan ◽

Adhie Nur Radityo ◽

Rina Pratiwi ◽

Kusmiyati Tjahjono

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Very Low Birth Weight ◽

Clinical Symptoms ◽

Control Group ◽

Characteristic Difference ◽

Human Milk Fortifier

Background: Human milk fortifier (HMF) is defined as a supplement added to breastmilk to increase calories, proteins, vitamins, and various nutrition of breastmilk. The purpose of HMF administration is to increase the concentration of breastmilk nutrients to improve the weight of very low birth weight preterm infants. The administration of HMF is insufficient to fulfill protein needs in 20-40% very low birth weight babies, thus the weight gain did not meet the expected target.Objective: To analyze characteristic differences between very low birth weight preterm infants who experienced weight gain according to the target and not according to the target on the administration of HMF.Methods: An analytical study with a case-control approach comparing case and control group, which was observed to determine characteristic differences between both groups. The samples were 52 very low birth weight preterm infants obtained by consecutive sampling. Data analysis includes descriptive analysis and hypothesis testing. Results: Data were obtained from medical records and consisted of 52 participants, including 26 very low birth weight premature infants who experienced weight gain according to the target and 26 who experienced weight gain not according to the target. There was no characteristic difference of cyanosis clinical symptoms (OR 2.3; 95% CI 0.51-10.4), chest retraction (OR 1.0; 95% CI 0.32-3.1), apnea of prematurity comorbid (OR 1.0; 95% CI 0.25-3.9), neonatal infections (OR 0.62; 95% CI 0.21-1.9), starting age of HMF administration (OR 0.62; 95% CI 0.21-1.89), bloating (OR 0.57; 95% CI 0.17-1.9), and vomiting (OR 1.18; 95% CI 0.38-3.7) in both groups.Conclusion: There was no characteristic difference between very low birth weight preterm infants who experienced weight gain according to the target and not according to the target on the administration of HMF.

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Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants

BMC Pediatrics ◽

10.1186/s12887-020-02394-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yan Xu ◽

Zhangbin Yu ◽

Qianqian Li ◽

Jinjun Zhou ◽

Xiaoguang Yin ◽

...

Keyword(s):

Quality Improvement ◽

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Very Low Birth Weight ◽

Research Database ◽

Vlbw Infants ◽

Dose Dependent

Abstract Background and aim Human milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, studies on the association between the dose of human milk and BPD in China are limited. This study aimed to evaluate the dose-dependent effects of human milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants. Methods This retrospective cohort study of preterm infants was conducted on preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. The multivariate analysis was performed to compare the effect outcomes of daily graded doses [1–24 mL/(kg · day), 25–49 mL/(kg · day), and ≥ 50 mL/(kg · day) of body weight] of human milk on neonatal outcomes throughout the first 4 weeks of life versus a reference group receiving no human milk. The models were adjusted for potential confounding variables. Results Of 964 included infants, 279 (28.9%) received exclusive preterm formula, 128 (13.3%) received 1–24 ml/(kg · day), 139 (14.4%) received 25–49 ml/(kg · day), and 418 (43.4%) received ≥50 ml/(kg · day) human milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of human milk daily [≥50 mL/(kg · day)] had lower incidences of BPD [27.5% in ≥50 mL/(kg · day) vs 40.1% in 0 mL/(kg · day) human milk, P = 0.001)], moderate and severe BPD [8.9% in ≥50 mL/(kg · day) vs 16.1% in 0 mL/(kg · day), P = 0.004], necrotizing enterocolitis [NEC; 3.8% in ≥50 mL/(kg · day) vs 10.8% in 0 mL/(kg · day), P = 0.001], late-onset sepsis [LOS; 9.3% in ≥50 mL/(kg · day) vs 19.7% in 0 mL/(kg · day), P <0.01], and extrauterine growth retardation [EUGR; 38.5% in ≥50 mL/(kg · day) vs 57.6% in 0 mL/(kg · day), P <0.01)]. The logistic regression indicated that those receiving ≥50 ml/kg · day human milk had lower odds of BPD [adjusted odds ratio (AOR) 0.453; 95% confidence interval (CI): 0.309, 0.666], moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979). Conclusions A daily threshold amount of ≥50 ml/(kg · day) human milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants. Trial registration ClinicalTrials.gov Identifier: NCT03453502. Registration date: March 5, 2018. This study was retrospectively registered.

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Effects of two modalities of noninvasive ventilation on breathing pattern of very low birth weight preterm infants immediately after extubation: a quasi-experimental study

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2021.1892063 ◽

2021 ◽

pp. 1-7

Author(s):

Bruna da Silva Pinto Pinheiro Vieira ◽

Leni Márcia Anchieta ◽

Daniella Rocha Cardoso ◽

Simone Nascimento Santos Ribeiro ◽

Giane Amorim Ribeiro-Samora ◽

...

Keyword(s):

Experimental Study ◽

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Noninvasive Ventilation ◽

Breathing Pattern ◽

Very Low Birth Weight ◽

Quasi Experimental

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

Nutrients ◽

10.3390/nu13113962 ◽

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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