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.

Wide Variability in Caloric Density of Expressed Human Milk Can Lead to Major Underestimation or Overestimation of Nutrient Content

2016 ◽  
Vol 33 (2) ◽  
pp. 341-350 ◽  
Author(s):  
Charles W. Sauer ◽  
Mallory A. Boutin ◽  
Jae H. Kim
Keyword(s):  
Human Milk ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Nutrient Content ◽  
Postnatal Growth ◽  
Low Birth Weight Infants ◽  
Caloric Density ◽  
Wide Variability ◽  
Fat Composition ◽  
Nutrition Strategy

Background: Very-low-birth-weight infants continue to face significant difficulties with postnatal growth. Human milk is the optimal form of nutrition for infants but may exhibit variation in nutrient content. Objective: This study aimed to perform macronutrient analysis on expressed human milk from mothers whose babies are hospitalized in the neonatal intensive care unit. Methods: Up to five human milk samples per participant were analyzed for protein, carbohydrate, and fat content using reference chemical analyses (Kjeldahl for protein, high pressure liquid chromatography for carbohydrates, and Mojonnier for fat). Calorie content was calculated. Results: A total of 64 samples from 24 participants was analyzed. Wide variability was found in calorie, protein, carbohydrate, and fat composition. The authors found an average of 17.9 kcal/ounce, with only 34% of samples falling within 10% of the expected caloric density. Conclusion: The assumption that human milk contains 20 kcal/ounce is no longer supported based on this study. This supports promoting an individualized nutrition strategy as a crucial aspect to optimal nutrition.

The Neutral Temperature of Very Low-Birth-Weight Infants

PEDIATRICS ◽  
1984 ◽  
Vol 74 (2) ◽  
pp. 288-289
Author(s):  
PIETER J. J. SAUER ◽  
HENK K. A. VISSER
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
American Academy ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Perinatal Care ◽  
Newborn Infants ◽  
Low Birth Weight Infants ◽  
American Academy Of Pediatrics ◽  
Neutral Temperature

Recently, guidelines for perinatal care were published by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.1 In a chapter on thermoregulation of newborn infants, recommendations for the neutral temperature of newborn infants are given. These recommendations are based on studies done more than 15 years ago.2,3 Although most of the recommendations are still valid, the values given for very low-birth-weight infants during the first week of life might need reconsideration based on more recent studies. In the original studies, infants were grouped by birth weight and not by gestational age. The group called the "smaller prematures" had a mean birth weight of 1,276 g; all weighed less than 1,500 g.

Factors Associated With Breastfeeding Very Low Birth Weight Infants at Neonatal Intensive Care Unit Discharge: A Single-Center Brazilian Experience

2020 ◽  
pp. 089033442098192
Author(s):  
Mariana González de Oliveira ◽  
Desirée de Freitas Valle Volkmer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Factors Associated ◽  
Breastfeeding Rates

Background The mothers of very low birth weight infants face many challenges to achieve breastfeeding at hospital discharge, especially during long stays. Research aim The aim of this study was to describe the incidence and factors associated with breastfeeding rates (exclusive or with formula) at discharge, for very low birth weight infants, in a private Neonatal Intensive Care Unit in southern Brazil. Methods We conducted a prospective longitudinal cohort study of infants ( N = 335) with very low birth weight and/or less than 30 weeks gestational age, who survived to discharge and had no contraindication to mother’s own milk. Participants were initially divided into three groups (exclusive breastfeeding, some breastfeeding, and no breastfeeding) based on their feedings at discharge; however, later, two groups were analyzed (any breastfeeding, no breastfeeding). Results Most (93.4%; n = 313) were breastfeeding directly at least once daily at discharge, of which 16.1% ( n = 54) were receiving exclusive mother’s milk and 77.3% ( n = 259) mixed feeding (mother’s milk and formula). Breastfeeding at discharge was associated with gestational age ≥ 28 weeks, higher birth weight, not developing neonatal sepsis or bronchopulmonary dysplasia during the hospital stay, shorter lengths of stay, and lower weight at discharge. After Poisson regression, breastfeeding at discharge was associated only with a shorter length of stay (RR 0.98; CI 95% [0.95, 0.99], p < .05). Conclusions In our single unit experience in Brazil, most infants were breastfeeding at discharge. NICU staff might address mothers of infants who have prolonged hospitalization with specific strategies. Mothers and infants at risk can be identified early and personalized interventions can be developed for improving breastfeeding rates at discharge.

Nutrition and Growth Analysis of Very Low Birth Weight Infants

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 378-383
Author(s):  
Tanis R. Fenton ◽  
Douglas D. McMillan ◽  
Reg S. Sauve
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Oral Nutrition ◽  
Growth And Nutrition ◽  
Audit Data ◽  
Appropriate For Gestational Age

The growth and nutrition of 220 very low birth weight infants were reviewed after comprehensive data on all infants in the hospital were entered into the Neonatal Intensive Care Unit Audit Data Base for 2 years prospectively. Fluid and energy (parenteral and oral) intakes were compared in four birth weight categories (1, ı750 g; 2, 751 to 1000 g; 3, l001 to 1250 g; 4, 1251 to 1500 g). Parenteral nutrition was the major source of first nutrition for the small infants, but seldom did it alone provide adequate nutrition for very low birth weight infants. The age of the first nutrition (parenteral and/or oral nutrition other than dextrose) decreased with increasing birth weight. The age of the first oral feedings was later for the infants of the lower birth weights but enteral feeding became the major nutrition for all weight categories by the second week of life. During the first 50 days the infants accumulated a deficit of 3780 to 5460 kJ relative to their estimated need of 504 kJ/kg per day, with the smaller infants accumulating a significantly larger deficit. The growth of infants appropriate for gestational age and of infants small for gestational age differed from each other and from the commonly used graph of Dancis et al (J Pediatr. 1948;33:570-572).

scholarly journals Differences in perceived parental stress between parents with very low birth weight infants and nurses in neonatal intensive care units, South Korea

2021 ◽  
Vol 27 (3) ◽  
pp. 297-307
Author(s):  
Seol-Hee Moon ◽  
Ho-Ran Park ◽  
Dong Yeon Kim
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Parental Stress ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Breathing Patterns ◽  
Low Birth Weight Infants ◽  
Significant Difference ◽  
Stress Score

Purpose: This descriptive study compared the perceived parental stress levels between parents with very low birth weight infants (VLBWIs) and nurses in the neonatal intensive care unit (NICU).Methods: In total, 83 parents of VLBWIs and 78 NICU nurses were enrolled. Data were collected with the Parental Stress Scale (PSS) and analyzed using the t-test and analysis of variance in SAS version 9.4.Results: The average PSS score was 3.31 among parents and 3.45 among nurses. The stress score was significantly higher among nurses with children (t=2.46, p=.016) and senior nurses (t=2.12, p=.037). There was a significant difference in the stress score according to parents' education (t=3.29, p=.002) and occupation (F=3.14, p=.049) in the sights and sounds subscale. Mothers had significantly higher stress scores than fathers in the parental role alterations subscale (t=2.32, p=.023). Parental stress scores were higher than those perceived by nurses in the infant's appearance and behaviors subscale for breathing patterns (t=2.95, p=.004), followed by jerky/ restless behavior (t=2.70, p=.008).Conclusion: Nurses should provide explanations to parents of VLBWIs in order to reduce parental stress about the appearances and behavior of VLBWIs. This is more important than aspect of the NICU environment and education about parental roles.

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 (&gt;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.

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