scholarly journals An open-label, pilot study to evaluate the benefits of using lyophilized human milk-derived nutritional product (NeoLact 70 – 1.55 g) as an immune-nutritional supplement in premature infants discharged from NICU

2022 ◽  
Vol 8 (12) ◽  
pp. 404-407
Author(s):  
Gowtham R ◽  
Anisha Afza ◽  
Shankar Shankar ◽  
Lingaraju Subbanna

Background: Premature and low birth weight (LBW) infants are at increased risk of having inadequate growth in post-discharge periods. In this study, lyophilized human milk was used as an immune-nutrition supplement along with breastfeeding for a period of 1 month in preterm infants discharged from neonatal intensive care unit (NICU). Objectives: Primary objective was to assess the percentage change in serum immunoglobulins for the duration of supplementation, and secondary objectives were to correlate changes in immunoglobulins to number of episodes of infections including respiratory infections and diarrhea, requirement of antibiotics, weight gain, and episodes of feed intolerance during the study period. Methods: A total of 10 preterm and LBW infants were included in the study at the time of discharge from NICU after satisfying the inclusion and exclusion criteria. The serum immunoglobulins were estimated at baseline and at end of the study, other parameters such as episodes of infections, feed intolerance, and weight gain were recorded on the weekly follow-up visits. All the infants received supplementation with NeoLact 70 – 1.55 g on a TID frequency along with the regular breastfeeding for a period of 1-month post-discharge from NICU and were followed up on a weekly basis. Results: Ten infants completed the study, mean birth weight and gestational age were 1779.4±576 gm and 33.5±4.9 weeks, respectively. There was increase in immunoglobulins IgA, IgE, IgG, and IgM by 38.29%, 85.36%, 17.45%, and 48.25%, respectively, from baseline to end of study. None of the infants experienced feeding intolerance, diarrhea, abdominal distension, fever, respiratory infections, or rehospitalizations, none of the infants required antibiotics or probiotics during the study period. The average weight gain in the 1st, 2nd, 3rd, and 4th week of supplementation was 28.42 g/day, 31.57 g/day, 35.17 g/day, and 39.24 g/day, respectively, with a mean weight gain of 30.4 g/day achieved for the entire duration of the study. Conclusion: The immune-nutritional supplementation with lyophilized human milk (NeoLact 70 – 1.55 g) helps to ensure exclusive human milk diet post-discharge and reduce the risk of infections, diarrhea, and rehospitalization through the enhancement of immunoglobulins and ensuring optimal weight gain. However, these results should be confirmed through multicentric studies with larger sample size. Supplementation with NeoLact 70 – 1.55 g can clinically benefit premature and LBW infants post-discharge.

PEDIATRICS ◽  
1980 ◽  
Vol 65 (4) ◽  
pp. 854-857
Author(s):  
Lewis A. Barness ◽  
Peter R. Dallman ◽  
Homer Anderson ◽  
Platon Jack Collipp ◽  
Buford L. Nichols ◽  
...  

The experience of Finnish workers, as well as that of others, shows that the banking of heattreated and frozen human milk is a practical and safe means of feeding low-birth-weight newborn infants. The continuous and exclusive use of human milk is associated with a low incidence of infection and with a rate of survival which is among the highest reported.4 The rate of growth and weight gain is also considered satisfactory, although there is some controversy about whether weight gain is quite as rapid as in formula-fed infants.28 Long-term studies should be carried out to see if these infants grow and develop as well, or better than, those on formula feedings. It is still uncertain whether banked human milk will prove sufficiently superior to formula with respect to its nutritional and immunologic characteristics to compensate for the difficulties of maintaining bacteriologic control and to warrant the cost of setting up and running a milk bank for premature infants. At this time, the Committee considers it optimal for mothers of low-birth-weight newborn infants to collect their milk for feeding their own infants fresh milk.29 Once home, the mothers can freeze the expressed milk and organize for transportation of samples on a regular basis. However, since this procedure will be impossible or impractical for many infants, bacteriologically safe milk from a donor seems a reasonable alternative for these infants.


2003 ◽  
Vol 6 (3) ◽  
pp. 241-247 ◽  
Author(s):  
G Rocquelin ◽  
S Tapsoba ◽  
J Kiffer ◽  
S Eymard-Duvernay

AbstractObjective:Objective: To estimate the role of human milkn-6 andn-3 polyunsaturated fatty acids (PUFA) in term infant growth in two African urban populations.Design:Observational study. Weight gains at 5 months of age and dietary habits were compared between Congolese infants (n=102) and Burkinabè infants (n=101). Socio-economic status and anthropometry of the mothers were also recorded.Setting:One suburban district in Brazzaville (capital of The Congo) and one in Ouagadougou (capital of Burkina Faso).Subjects:Two random samples of nursing mothers and their 5-month-old infants.Results:All infants were born at term and there was no difference in birth weights. At 5 months of age, infants in Ouagadougou were thinner but not shorter than their counterparts in Brazzaville (average weight gain (standard deviation): 614 (168) g month-1vs. 720 (176) g month-1;P>0.0001). Drastic differences were found in infant diets with regard to extra fluid intake andn-6 andn-3 PUFA concentrations in breast milk. In Ouagadougou, all infants were given fluids other than milk from birth. Breast milk had highly unbalanced 18:2n-6/18:3n-3 andn-6/n-3 long-chain PUFA ratios (53:1 and 5:1, respectively). In Brazzaville, half of the infants received fluids other than milk, and breast milk showed balanced 18:2n-6/18:3n-3 andn-6/n-3 long-chain PUFA ratios (12:1 and 1:1, respectively). A non-linear relationship between 18:2n-6/18:3n-3 ratio and growth was established in Brazzaville (P=0.0027). The 18:2n-6/18:3n-3 ratio adjusted with covariates had an even more significant effect on weight gain (P=0.0011). Applying the same model in Ouagadougou did not show such a relation.Conclusion:Data strongly suggest that a balanced ratio of 18:2n-6/18:3n-3 (between 5:1 and 15:1) in breast milk leads to higher weight gain of infants during the first 5 months of life.


2018 ◽  
Vol 107 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Laura Morlacchi ◽  
Paola Roggero ◽  
Maria Lorella Giannì ◽  
Beatrice Bracco ◽  
Debora Porri ◽  
...  

2021 ◽  
Author(s):  
Ana M Ramos-Levi ◽  
Gemma Rodriguez-Carnero ◽  
Cristina Garcia-Fontao ◽  
Antia Fernandez-Pombo ◽  
Paula Andújar-Plata ◽  
...  

Abstract Background. Obesity and gestational diabetes mellitus (GDM) are associated to increased risk of perinatal complications and obesity in the offspring. However, the impact of gestational weight gain (GWG) on maternal and fetal outcomes has led to controversial results. Research design and methods. Retrospective study of 220 women with GDM and pre-pregnancy body mass index (BMI) ≥ 30 kg/m2. Pregnant women were classified according to the Institute of Medicine (IOM) recommendations regarding prior BMI and GWG. We evaluated the impact of GWG on birth weight and perinatal outcomes. Results. Mean maternal age was 34.7±5.3 years. Pre-pregnancy obesity was classified as grade I in 55.3% of cases, grade II in 32.0%, and grade III in 12.7%. GWG was adequate (5-9kg) in 24.2%, insufficient (< 5kg) in 41.8% and excessive (> 9kg) in 34.2%. Birthweight was within normal range in 81.9%, 3.6% were small for gestational age (SGA) and 14.4% were large for gestational age (LGA). Insufficient GWG was associated to a higher rate of SGA offspring, excessive GWG was associated to LGA and adequate GWG to normal birth weight. Conclusion. GWG in women with pre-pregnancy obesity and GDM impacts neonatal birthweight. Insufficient GWG is associated to SGA and excessive GWG is associated to LGA. Women with adequate GWG according to IOM guidelines obtained better perinatal outcomes.


2021 ◽  
Vol 5 ◽  
pp. 82
Author(s):  
Martha Mwangome ◽  
Moses Ngari ◽  
Paluku Bahwere ◽  
Patrick Kabore ◽  
Marie McGrath ◽  
...  

Background: Wasting and underweight in infancy is an increasingly recognised problem but consensus on optimum assessment is lacking.  In particular, there is uncertainty on how to interpret anthropometry among low birth weight (LBW) infants who may be growing normally. This research aimed to determine growth of infants from birth to two months (around age of vaccination) and the mortality risk of underweight LBW infants compared to normal birth weight (NBW) infants at two and six months age. Methods: A secondary analysis of a birth cohort of 1103 infants in Burkina Faso was conducted. Anthropometry was performed monthly from 0 to 12 months. We assessed associations with mortality using Cox proportional hazards models and assessed discriminatory values using area under receiver operating characteristics curves. Results: Eighty-six (7.8%) children died by age one year, 26/86 (30%) and 51/86 (59%) within two and six months, respectively. At age two months, weight gain since birth did not better discriminate mortality risk than current weight-for-age (P=0.72) or mid-upper arm circumference (P=0.21). In total, 227 (21%) LBW infants had increased risk of mortality: adjusted hazards ratio (aHR) 3.30 (95%CI 2.09 to 4.90).  Among infants who were underweight at two and six months, LBW infants (64% and 49%, respectively) were not at reduced risk of death compared to NBW infants (aHR 2.63 (95%CI 0.76 to 9.15) and 2.43 (95%CI 0.74 to 7.98), respectively). Conclusion: Assessing weight gain since birth does not offer advantages over immediate anthropometry for discriminating mortality risk. LBW infants who are later identified as underweight require care to help prevent mortality.


1994 ◽  
Vol 18 (4) ◽  
pp. 474-477 ◽  
Author(s):  
Christina J. Valentine ◽  
Nancy M. Hurst ◽  
Richard J. Schanler

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yaser Abdallah ◽  
Flavia Namiiro ◽  
Jolly Nankunda ◽  
Jamiru Mugalu ◽  
Yvonne Vaucher

Abstract Early discharge of preterm very low birth weight (VLBW) infants is at times inevitable in low resource settings. The implication of such practice on the growth of this high-risk population is not known. We conducted a retrospective chart review to describe the growth of preterm VLBW infants discharged with a weight of less than 1500 g. Objectives To describe the growth of discharged preterm VLBW infants over the first 12 weeks. Method Between June 2013 and January 2014; 164 discharged preterm VLBW infants were followed up for 3 months. Among the survivors (132), we identified 111 infant records for this study. Relevant data was entered in STATA for analysis. Growth percentiles were determined at approximately 4 weeks, 8 weeks, and 12 weeks post-discharge using the intergrowth 21st growth charts. Growth velocities were computed using the 2-point average weight model. Regression analysis was used to identify factors associated with growth failure. Growth failure was defined as occipital frontal circumference (OFC), weight, and length < 10th centile by 12 weeks post-discharge. P-value of < 0.05 was considered significant at a 95% confidence interval. Results Among the study infants the median gestational age and weight at birth were 32 weeks (range 28-35 weeks) and 1250 g(range 850-1500 g) respectively; 60/111(54%) were Small for Gestational Age (SGA). The median discharge postmenstrual age (PMA) was 34 weeks (range 30-38 weeks) and weight was 1140 g (range 830-1490 g). The majority 88.2% had not recovered birth weight at discharge of whom 59.1% recovered by 2 weeks and 40.9% recovered between 2 and 4 weeks after discharge. By 12 weeks post-discharge the median PMA and weight were 46 weeks (range 37-51 weeks),and 3110 g (range 1750-5000 g) respectively, 38.7% of the infants had growth failure and 36.9% had OFC <3rd centile. Growth velocity < 15 g/kg/d in the first 4 weeks (OR 3.8, p 0.010) and subsequent 4 weeks (OR 2.5, p 0.049) post-discharge were independently associated with growth failure. Conclusion Slow birth weight recovery was observed and growth failure was prevalent by 12 weeks post-discharge with more than a third having severe microcephaly. Poor post-discharge growth velocity was associated with subsequent growth failure. Recommendations Growth velocity monitoring among preterm VLBW infants should be emphasized. The implication and interventions of this early growth failure needs to be explored.


2021 ◽  
Vol 55 (9) ◽  
Author(s):  
Janelle Margaux M. Logronio ◽  
Maria Esterlita T. Villanueva-Uy ◽  
Socorro De Leon-Mendoza

Background. The Neonatal Intensive Care Unit (NICU) admission at the Philippine General Hospital (PGH) exceeds total bed capacity. Decreasing admissions to the NICU would prevent overcrowding of patients, improve patient care, reduce hospital stay, and reduce predisposition to hospital-acquired infections. Objective. To determine the effect of continuous versus intermittent Kangaroo Mother Care (KMC) on weight gain and duration of hospital stay among low birth weight (LBW) neonates weighing 1,800 - 2,220 grams. Methods. Forty-six (46) stable LBW were randomized to either continuous (≥12 hours in the maternity ward) or intermittent (≤6 hours in the NICU step-down unit) KMC groups. Daily weight and weekly length, head and chest circumference until discharge, and duration of hospital stay were measured. Data were analyzed using the Mann-Whitney U-test and Fisher's exact test. Results. Infants in continuous KMC had an average weight gain of 50 grams/day (p=0.509) and had an average duration of hospital stay of 3 days (p=0.218). Results were not statistically different from intermittent KMC. Conclusion. There was no evidence to show that weight gain and duration of hospital stay among infants in continuous KMC were significantly different from those in the intermittent KMC group.


Sign in / Sign up

Export Citation Format

Share Document