scholarly journals Modifications of Own Mothers’ Milk Fortification Protocol Affect Early Plasma IGF-I and Ghrelin Levels in Preterm Infants. A Randomized Clinical Trial

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 3056
Author(s):  
Eleni Agakidou ◽  
Thomais Karagiozoglou-Lampoudi ◽  
Elisavet Parlapani ◽  
Dimitrios J. Fletouris ◽  
Kosmas Sarafidis ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Preterm Infants ◽  
Plasma Levels ◽  
Protein Intake ◽  
Protein Targeting ◽  
Growth Parameter ◽  
Transient Effect ◽  
Protein Energy ◽  
Igf I ◽  
Z Scores

The aim was to investigate the effect of two own mother’s milk (OMM) fortification protocols on (a) IGF-I and ghrelin plasma levels at 35 post-conceptional weeks (PCW, T2) and whether this effect is maintained after elimination of the differences in OMM fortification, and (b) growth until 12 months corrected age. Forty-eight OMM-fed preterm infants (GA 24–32 weeks) were randomly allocated to the fixed-fortification (FF) group (n = 23) and the protein-targeting fortification (PTF) group (n = 25) targeting the recommended daily protein intake (PI). Plasma IGF-I and ghrelin were assessed at 35 (T2) and 40 (T3) PCW while growth was longitudinally assessed until 12 months corrected age. PTF group had lower IGF-I and higher ghrelin than FF group at T2, while receiving lower daily protein and energy amounts. PI correlated positively to T2-IGF-I and inversely to T3-ghrelin while energy intake (EI) correlated inversely to T2- and T3-ghrelin. Group and PI were independent predictors of adjusted T2-IGF-I, while group and EI were predictors of adjusted and T2-ghrelin. Growth parameter z-scores were comparable between groups up to 12 months corrected age. Modifications of OMM fortification have a transient effect on early plasma IGF-I and ghrelin levels in preterm infants in a way consistent with the previously recognized protein-energy/endocrine balance, indicating a potential programming effect.

Higher Protein Intake Improves Length, Not Weight, z Scores in Preterm Infants

2014 ◽  
Vol 58 (4) ◽  
pp. 409-416 ◽  
Author(s):  
Irene E. Olsen ◽  
Cheryl L. Harris ◽  
M. Louise Lawson ◽  
Carol L. Berseth
Keyword(s):  
Preterm Infants ◽  
Protein Intake ◽  
Z Scores

Associations of IGF-1 gene variants and milk protein intake with IGF-I concentrations in infants at age 6months — Results from a randomized clinical trial

2013 ◽  
Vol 23 (5) ◽  
pp. 149-158 ◽  
Author(s):  
Peter Rzehak ◽  
Veit Grote ◽  
Eva Lattka ◽  
Martina Weber ◽  
Dariusz Gruszfeld ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Protein Intake ◽  
Milk Protein ◽  
Gene Variants ◽  
Igf I

scholarly journals Expressed Breast Milk Analysis: Role of Individualized Protein Fortification to Avoid Protein Deficit After Preterm Birth and Improve Infant Outcomes

2022 ◽  
Vol 9 ◽  
Author(s):  
Sharmeel Khaira ◽  
Antoinette Pert ◽  
Emily Farrell ◽  
Cecelia Sibley ◽  
Karen Harvey-Wilkes ◽  
...  
Keyword(s):  
Breast Milk ◽  
Protein Content ◽  
Body Mass ◽  
Protein Intake ◽  
Specific Protein ◽  
Protein Supplementation ◽  
Milk Analysis ◽  
Protein Energy ◽  
Expressed Breast Milk ◽  
Z Scores

Background: Expressed breast milk (EBM) protein content is highly variable between mothers and often below published values that are still used for EBM protein fortification strategies. This approach may result in significant protein deficit and suboptimal protein energy (P/E) ratio. The study aim was to determine whether individualized EBM protein analysis and fortification will reduce preterm infant protein deficits and improve growth and neurodevelopmental outcome.Study Methods: In a single-center randomized, blinded study of infants born at 24 0/7–29 6/7 weeks, mother-specific protein values measured by a milk analyzer were used to individualize infant-specific protein intake (interventional group, IG), and compared this to a standardized protein fortification scheme based on published values of EBM protein content of 1.4 g/dL (control group, CG). For IG, milk analyzer protein values of mother's EBM were used to adjust protein content of the EBM. The CG EBM protein content was adjusted using the standard published value of 1.4 g/dL and not based on milk analyzer values. EBM protein content, protein intake, protein/energy (P/E) ratio, weight (WT), head circumference (HC), length (L), growth velocity (GV) from 2 to 6 weeks of age, WT, HC and L Z-Scores at 32- and 35-weeks PMA, and lean body mass (35 weeks PMA skin fold thickness) were measured. Neurodevelopment was assessed by Bayley III at average 24 months corrected gestational age (CGA).Results: EBM protein content before fortification was significantly below published values of 1.4 g/dL at all time points in both CG and IG. CG protein deficit was significantly decreased and progressively worsened throughout the study. Individualized protein fortification in IG avoided protein deficit and optimized P/E ratio. Although no significant change in short-term GV (at 6 weeks of age) was seen between groups, IG infants born at <27 weeks had significant improvements in WT and L z-scores, and leaner body mass at 32 and 35 weeks PMA. IG exhibited significantly improved cognitive scores at 24 months CGA.Conclusions: Infant-specific protein supplementation of mother's EBM optimized P/E ratio by eliminating protein deficit and improved growth z scores at 32- and 35-weeks PMA and neurocognitive testing at 24 months.

scholarly journals Postnatal Decrease in Circulating Insulin-Like Growth Factor-I and Low Brain Volumes in Very Preterm Infants

2011 ◽  
Vol 96 (4) ◽  
pp. 1129-1135 ◽  
Author(s):  
Ingrid Hansen-Pupp ◽  
Holger Hövel ◽  
Ann Hellström ◽  
Lena Hellström-Westas ◽  
Chatarina Löfqvist ◽  
...  
Keyword(s):  
White Matter ◽  
Magnetic Resonance ◽  
Preterm Infants ◽  
Brain Volumes ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Matter Volume ◽  
Total Brain ◽  
Igf I ◽  
Igfbp 3

Abstract Context: IGF-I and IGF binding protein-3 (IGFBP-3) are essential for growth and maturation of the developing brain. Objective: The aim of this study was to evaluate the association between postnatal serum concentrations of IGF-I and IGFBP-3 and brain volumes at term in very preterm infants. Design: Fifty-one infants with a mean (sd) gestational age (GA) of 26.4 (1.9) wk and birth weight (BW) of 888 (288) g were studied, with weekly blood sampling of IGF-I and IGFBP-3 from birth until 35 gestational weeks (GW) and daily calculation of protein and caloric intake. Magnetic resonance images obtained at 40 GW were segmented into total brain, cerebellar, cerebrospinal fluid, gray matter, and unmyelinated white matter volumes. Main Outcome Measures: We evaluated brain growth by measuring brain volumes using magnetic resonance imaging. Results: Mean IGF-I concentrations from birth to 35 GW correlated with total brain volume, unmyelinated white matter volume, gray matter volume, and cerebellar volume [r = 0.55 (P < 0.001); r = 0.55 (P < 0.001); r = 0.44 (P = 0.002); and r = 0.58 (P < 0.001), respectively]. Similar correlations were observed for IGFBP-3 concentrations. Correlations remained after adjustment for GA, mean protein and caloric intakes, gender, severe brain damage, and steroid treatment. Protein and caloric intakes were not related to brain volumes. Infants with BW small for GA had lower mean concentrations of IGF-I (P = 0.006) and smaller brain volumes (P = 0.001–0.013) than infants with BW appropriate for GA. Conclusion: Postnatal IGF-I and IGFBP-3 concentrations are positively associated with brain volumes at 40 GW in very preterm infants. Normalization of the IGF-I axis, directly or indirectly, may support normal brain development in very preterm infants.

Effects of oral stimulation with breast milk in preterm infants oral feeding: a randomized clinical trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Qiong Le ◽  
Sheng-hua Zheng ◽  
Lan Zhang ◽  
Li-fen Wu ◽  
Feng-juan Zhou ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Breast Milk ◽  
Premature Infant ◽  
Preterm Infants ◽  
Oral Feeding ◽  
Transition Time ◽  
Control Group ◽  
Oral Motor ◽  
Oral Stimulation ◽  
Nutritive Sucking

Abstract Objectives This study was performed to evaluate the effect of oral stimulation with breast milk for preterm infants. Methods A total of 68 subjects form neonatal intensive care unit were randomly assigned into control group (n=20), premature infant oral motor intervention (PIOMI) group (n=25) and premature infant oral motor intervention with breast milk (BM-PIOMI) group (n=23). Results BM-PIOMI group had significant shorter initiation of oral feeding (IOF) time compared to PIOMI group (2.95 days, 95% CI [0.42–5.48]) or control group (9.79 days, 95% CI [7.07–12.51]). BM-PIOMI group had significant sooner transition time from IOF to full oral feeding (FOF) compared to control group (6.68 days, 95% CI [2.2–11.16]), but not to PIOMI group (2.09 days, 95% CI [−2.07 to 6.25]). Length of hospital stay (LOS) did not show statistical different between three groups (control 38.85 ± 14.40 vs. PIOMI 38.48 ± 11.76 vs. BM-PIOMI 38.04 ± 12.2). Growth mixture model identified improvement in non-nutritive sucking (NNS) score in BM-PIOMI group compared to control and PIOMI group (0.8293, p<0.0001, and 0.8296, p<0.0001, respectively). Conclusions Oral stimulation with breast milk can better promotes the oral feeding process of premature infants than the simple oral stimulation, by shorten IOF time and improve early NNS score, but does not shorten transition time from IOF to FOF and LOS. Trial registration The trial identification number is ChiCTR1800019134 (Chinese Clinical Trial Registry http://www.who.int/ictrp/network/chictr2/en/)

The Effect of Protein Intake on Composition of Weight Gain in Preterm Infants

1987 ◽  
pp. 143-149
Author(s):  
G. Putet ◽  
J. Rigo ◽  
B. Salle ◽  
J. Senterre
Keyword(s):  
Weight Gain ◽  
Preterm Infants ◽  
Protein Intake

scholarly journals Nutritional Intake, White Matter Integrity, and Neurodevelopment in Extremely Preterm Born Infants

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3409
Author(s):  
Lisa M. Hortensius ◽  
Els Janson ◽  
Pauline E. van van Beek ◽  
Floris Groenendaal ◽  
Nathalie H. P. Claessens ◽  
...  
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
Motor Development ◽  
Protein Intake ◽  
Diffusion Tensor ◽  
Neurodevelopmental Outcome ◽  
White Matter Integrity ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Preterm Born

Background: Determining optimal nutritional regimens in extremely preterm infants remains challenging. This study aimed to evaluate the effect of a new nutritional regimen and individual macronutrient intake on white matter integrity and neurodevelopmental outcome. Methods: Two retrospective cohorts of extremely preterm infants (gestational age <28 weeks) were included. Cohort B (n = 79) received a new nutritional regimen, with more rapidly increased, higher protein intake compared to cohort A (n = 99). Individual protein, lipid, and caloric intakes were calculated for the first 28 postnatal days. Diffusion tensor imaging was performed at term-equivalent age, and cognitive and motor development were evaluated at 2 years corrected age (CA) (Bayley-III-NL) and 5.9 years chronological age (WPPSI-III-NL, MABC-2-NL). Results: Compared to cohort A, infants in cohort B had significantly higher protein intake (3.4 g/kg/day vs. 2.7 g/kg/day) and higher fractional anisotropy (FA) in several white matter tracts but lower motor scores at 2 years CA (mean (SD) 103 (12) vs. 109 (12)). Higher protein intake was associated with higher FA and lower motor scores at 2 years CA (B = −6.7, p = 0.001). However, motor scores at 2 years CA were still within the normal range and differences were not sustained at 5.9 years. There were no significant associations with lipid or caloric intake. Conclusion: In extremely preterm born infants, postnatal protein intake seems important for white matter development but does not necessarily improve long-term cognitive and motor development.

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