Impact of Donor Human Milk in the Preterm Very Low Birth Weight Gut Transcriptome Profile by Use of Exfoliated Intestinal Cells

Background: Own mother’s milk (OMM) is the optimal nutrition for preterm infants. However, pasteurized donor human milk (DHM) is a valid alternative. We explored the differences of the transcriptome in exfoliated epithelial intestinal cells (EEIC) of preterm infants receiving full feed with OMM or DHM. Methods: The prospective observational study included preterm infants ≤ 32 weeks’ gestation and/or ≤1500 g birthweight. Total RNA from EEIC were processed for genome-wide expression analysis. Results: Principal component analysis and unsupervised hierarchical clustering analysis revealed two clustered groups corresponding to the OMM and DHM groups that showed differences in the gene expression profile in 1629 transcripts. The OMM group overexpressed lactalbumin alpha gene (LALBA), Cytochrome C oxidase subunit I gene (COX1) and caseins kappa gene (CSN3), beta gene (CSN2) and alpha gene (CSN1S1) and underexpressed Neutrophil Cytosolic Factor 1 gene (NCF1) compared to the DHM group. Conclusions: The transcriptomic analysis of EEIC showed that OMM induced a differential expression of specific genes that may contribute to a more efficient response to a pro-oxidant challenge early in the postnatal period when preterm infants are at a higher risk of oxidative stress. The use of OMM should be strongly promoted in preterm infants.

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A Systematic Review and Meta-Analysis of Human Milk Feeding and Short-Term Growth in Preterm and Very Low Birth Weight Infants

Nutrients ◽

10.3390/nu13062089 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2089

Author(s):

Machiko Suganuma ◽

Alice R. Rumbold ◽

Jacqueline Miller ◽

Yan Fong Chong ◽

Carmel T. Collins

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Very Low Birth Weight ◽

Meta Analysis ◽

Poor Quality ◽

Low Birth Weight Infants ◽

Preterm Formula ◽

Meta Analyses

Human milk (HM) is the gold standard for feeding infants but has been associated with slower growth in preterm infants compared with preterm formula. This systematic review and meta-analysis summarises the post-1990 literature to examine the effect of HM feeding on growth during the neonatal admission of preterm infants with birth weight ≤1500 g and/or born ≤28 weeks’ gestation. Medline, PubMed, CINAHL, and Scopus were searched, and comparisons were grouped as exclusive human milk (EHM) vs. exclusive preterm formula (EPTF), any HM vs. EPTF, and higher vs. lower doses of HM. We selected studies that used fortified HM and compared that with a PTF; studies comparing unfortified HM and term formula were excluded. Experimental and observational studies were pooled separately. The GRADE system was used to evaluate risk of bias and certainty of evidence. Forty-four studies were included with 37 (n = 9963 infants) included in the meta-analyses. In general, due to poor quality studies, evidence of the effect of any HM feeds or higher versus lower doses of HM was inconclusive. There was a possible effect that lower doses of HM compared with higher doses of HM improved weight gain during the hospital admission, and separately, a possible effect of increased head circumference growth in infants fed EPTF vs. any HM. The clinical significance of this is unclear. There was insufficient evidence to determine the effects of an exclusive HM diet on any outcomes.

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Tolerance of preterm formula versus pasteurized donor human milk in very preterm infants: a randomized non-inferiority trial

Italian Journal of Pediatrics ◽

10.1186/s13052-018-0532-7 ◽

2018 ◽

Vol 44 (1) ◽

Cited By ~ 5

Author(s):

Simonetta Costa ◽

Luca Maggio ◽

Giovanni Alighieri ◽

Giovanni Barone ◽

Francesco Cota ◽

...

Keyword(s):

Human Milk ◽

Preterm Infants ◽

Very Preterm Infants ◽

Very Preterm ◽

Donor Human Milk ◽

Preterm Formula

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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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Donor Human Milk for Preterm Infants

PEDIATRICS ◽

10.1542/peds.2012-1647c ◽

2012 ◽

Vol 130 (2) ◽

pp. e462-e462 ◽

Cited By ~ 3

Author(s):

W. McGuire

Keyword(s):

Human Milk ◽

Preterm Infants ◽

Donor Human Milk

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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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Donor human milk for preterm infants: Practice considerations

Journal of Neonatal Nursing ◽

10.1016/j.jnn.2013.04.002 ◽

2013 ◽

Vol 19 (4) ◽

pp. 175-181 ◽

Cited By ~ 6

Author(s):

Sharyn Gibbins ◽

Sabrina E. Wong ◽

Sharon Unger ◽

Deborah O'Connor

Keyword(s):

Human Milk ◽

Preterm Infants ◽

Donor Human Milk

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Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

10.20944/preprints201801.0107.v1 ◽

2018 ◽

Author(s):

Eduardo Villamor-Martínez ◽

Maria Pierro ◽

Giacomo Cavallaro ◽

Fabio Mosca ◽

Boris W. Kramer ◽

...

Keyword(s):

Systematic Review ◽

Human Milk ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Observational Studies ◽

Meta Analysis ◽

Very Preterm Infants ◽

Very Preterm ◽

Donor Human Milk ◽

Preterm Formula

Bronchopulmonary dysplasia (BPD) is the most common complication after preterm birth. Pasteurized donor human milk (DHM) has increasingly become the standard of care for very preterm infants over the use of preterm formula (PF) if mother’s own milk (MOM) is unavailable. Studies have reported beneficial effects of DHM on BPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies on the effects of DHM on BPD and other respiratory outcomes. Eighteen studies met the inclusion criteria. Meta-analysis of RCT’s could not demonstrate that supplementation of MOM with DHM reduced BPD when compared to PF (3 studies, risk ratio [RR] 0.89, 95% confidence interval [CI] 0.60–1.32). However, meta-analysis of observational studies showed that DHM supplementation reduced BPD (8 studies, RR 0.78, 95% CI 0.67–0.90). An exclusive human milk diet reduced the risk of BPD, compared to a diet with PF and/or bovine milk-based fortifier (3 studies, RR 0.80, 95% CI 0.68–0.95). Feeding raw MOM, compared to feeding pasteurized MOM, protected against BPD (2 studies, RR 0.77, 95% CI 0.62–0.96). In conclusion, our data suggest that DHM protects against BPD in very preterm infants, but pasteurization of human milk reduces the benefit.

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