Comparison of Very Low Birth Weight Preterm Infants with And Without Experienced Target Weight Gain on The Administration of 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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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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The Potential Effects of Human Milk on Morbidity in Very-Low-Birth-Weight Preterm Infants

Nutrients ◽

10.3390/nu12061882 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1882

Author(s):

Paola Roggero ◽

Nadia Liotto ◽

Orsola Amato ◽

Fabio Mosca

Keyword(s):

Quality Of Care ◽

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Very Low Birth Weight ◽

Mortality And Morbidity ◽

Vlbw Infants

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

PLoS ONE ◽

10.1371/journal.pone.0210999 ◽

2019 ◽

Vol 14 (2) ◽

pp. e0210999 ◽

Cited By ~ 1

Author(s):

Mariana M. Oliveira ◽

Davi C. Aragon ◽

Vanessa S. Bomfim ◽

Tânia M. B. Trevilato ◽

Larissa G. Alves ◽

...

Keyword(s):

Experimental Study ◽

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Very Low Birth Weight

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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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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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Preventive Effect of Bifidobacterium Supplementation on Neonatal Cholestasis in Preterm Neonates with Very Low Birth Weight

Gastroenterology Research and Practice ◽

10.1155/2020/4625315 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Gaohong Wu ◽

Xiaoqian Chen ◽

Ningxun Cui ◽

Yunxia He ◽

Jiaying Fan ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Very Low Birth Weight ◽

Group Versus ◽

Preterm Neonates ◽

Control Group ◽

Neonatal Cholestasis ◽

Biochemical Tests ◽

Significant Difference

Background. Cholestasis is a common but serious clinical condition in preterm neonates. The current management for preterm neonatal cholestasis has limitations. The aim of this study was to determine effects of Bifidobacterium supplementation on the prevention and alleviation of cholestasis in preterm infants with very low birth weight. Methods. Preterm neonates with very low birth weight were enrolled in the Children’s Hospital of Soochow University between December 2012 and December 2017. The patients were randomly assigned into Bifidobacterium and control groups, and effects of Bifidobacterium supplementation on the outcomes were compared between the two groups. Results. There was no significant difference in the baseline characteristics in the two groups. Notably, the proportion of cases with neonatal cholestasis was significantly lower, with fewer neonatal cholestasis-associated complications in the Bifidobacterium group compared with the control group (6% versus 22%, P<0.01). Furthermore, the Bifidobacterium group exhibited less severe cholestasis and better improvement of the liver function than the control group as evidenced by the biochemical tests (P<0.05). Finally, comparison of the other outcomes revealed that significant shorter duration of hospitalization (14.45±2.13 versus 16.12±2.22 days, P<0.01), fewer days to reach the full enteral feeding (9.2±2.11 versus 12±5.67 days, P<0.01), shorter duration of meconium passage (5.0±3.6 versus 6.6±3.38 days, P<0.05), lower proportion of cases on fasting and duration of fasting (0.8% versus 5.6%, P<0.05 and 3.0±1.6 versus 5.6±2.38 days, P<0.01, respectively), and shorter duration of weight gain to normal (4.77±2.49 versus 6.87±2.71 days, P<0.01) in the Bifidobacterium group versus the control group. Conclusions. Bifidobacterium supplementation has significantly preventive and other beneficial effects on the management of cholestasis in preterm infants with very low birth weight. Its long-term safety and effectiveness will need further investigation. This trial is registered with the Chinese Clinical Trial Registry (Registration No. ChiCTR1900022296).

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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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Role of human milk fortifier on weight gain in very low birth weight babies

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180479 ◽

2018 ◽

Vol 5 (2) ◽

pp. 353

Author(s):

Ganesh K. Verma ◽

Amitesh Yadav

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Very Low Birth Weight ◽

Postnatal Growth ◽

Medical Sciences ◽

Low Birth Weight Babies ◽

Mean Time

Background: Poor weight gain and postnatal growth of VLBW neonates continues to be a major problem. Breast feeding with HMF fortification show positive effect on growth. Main objective is to study the weight gain pattern in very low birth weight babies supplemented with HMF.Methods: This is an observational study conducted in NICU, Department of Pediatrics, U.P. Rural Institute of Medical Sciences and research Saifai, India between January 2015- June 2016 for assessing the weight gain pattern in VLBW neonates supplemented with HMF.Results: Maximum number of babies supplemented with HMF achieved the targeted weight in 8-14 days (32.2%) followed by those who attained this weight within 15-21 days (30%), 22-28 days (21.1%), <7 days (13.3%) and >28 days (3.3%) respectively. Mean time taken to achieve the targeted weight was 16.69±7.19 days.Conclusions: We concluded that the supplementation with HMF, can result in a significant increase in growth. We demonstrated that fortification of human milk, with HMF did not cause any measured adverse effects in VLBW neonates.

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