scholarly journals Human Milk Feeding and Preterm Infants’ Growth and Body Composition: A Literature Review

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1155 ◽  
Author(s):  
Jacopo Cerasani ◽  
Federica Ceroni ◽  
Valentina De Cosmi ◽  
Alessandra Mazzocchi ◽  
Daniela Morniroli ◽  
...  
Keyword(s):  
Body Composition ◽  
Literature Review ◽  
Human Milk ◽  
Preterm Infants ◽  
Cost Effective ◽  
Postnatal Growth ◽  
Fat Free Mass ◽  
Neurodevelopmental Outcomes ◽  
Adverse Health Outcomes ◽  
Milk Feeding

Preterm infants may show a higher risk of adverse health outcomes, such as the development of metabolic syndrome and cognitive impairment. The most recent evidence highlights that nutrition, body composition development, and early postnatal growth may play a role in the programming of these processes. Human milk feeding has been recommended as the natural feeding for preterm infants and as a cost-effective strategy for reducing disease and economic burden. Considering that the postnatal growth retardation and aberrant body composition shown by preterm infants at the time of hospital discharge still remain important issues, we performed a literature review, aiming to provide an update about the effect of human milk feeding on these processes. On the basis of our findings, human milk feeding in preterm infants, although related to a slower weight gain than formula feeding, is associated with a better recovery of body composition through the promotion of fat-free mass deposition, which may ultimately lead to better metabolic and neurodevelopmental outcomes. Promotion and support of human milk feeding should be considered a priority in preterm infants’ care.

scholarly journals Energy Expenditure, Protein Oxidation and Body Composition in a Cohort of Very Low Birth Weight Infants

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3962
Author(s):  
Michela Perrone ◽  
Camilla Menis ◽  
Pasqua Piemontese ◽  
Chiara Tabasso ◽  
Domenica Mallardi ◽  
...  
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Energy Expenditure ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Protein Oxidation ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Low Birth Weight Infants

The nutritional management of preterm infants is a critical point of care, especially because of the increased risk of developing extrauterine growth restriction (EUGR), which is associated with worsened health outcomes. Energy requirements in preterm infants are simply estimated, so the measurement of resting energy expenditure (REE) should be a key point in the nutritional evaluation of preterm infants. Although predictive formulae are available, it is well known that they are imprecise. The aim of our study was the evaluation of REE and protein oxidation (Ox) in very low birth weight infants (VLBWI) and the association with the mode of feeding and with body composition at term corrected age. Methods: Indirect calorimetry and body composition were performed at term corrected age in stable very low birth weight infants. Urinary nitrogen was measured in spot urine samples to calculate Ox. Infants were categorized as prevalent human milk (HMF) or prevalent formula diet (PFF). Results: Fifty VLBWI (HMF: 23, PFF: 27) were evaluated at 36.48 ± 0.85 post-conceptional weeks. No significant differences were found in basic characteristics or nutritional intake in the groups at birth and at the assessment. No differences were found in the REE of HMF vs. PFF (59.69 ± 9.8 kcal/kg/day vs. 59.27 ± 13.15 kcal/kg/day, respectively). We found statistical differences in the protein-Ox of HMF vs. PFF (1.7 ± 0.92 g/kg/day vs. 2.8 ± 1.65 g/kg/day, respectively, p < 0.01), and HMF infants had a higher fat-free mass (kg) than PFF infants (2.05 ± 0.26 kg vs. 1.82 ± 0.35 kg, respectively, p < 0.01), measured with air displacement plethysmography. Conclusion: REE is similar in infants with a prevalent human milk diet and in infants fed with formula. The HMF infants showed a lower oxidation rate of proteins for energy purposes and a better quality of growth. A greater amount of protein in HMF is probably used for anabolism and fat-free mass deposition. Further studies are needed to confirm our hypothesis.

scholarly journals Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 145 ◽  
Author(s):  
Sara E. Ramel ◽  
Jacob Haapala ◽  
Jennifer Super ◽  
Christopher Boys ◽  
Ellen W. Demerath
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Neurodevelopmental Outcomes ◽  
Prospective Longitudinal Study ◽  
Z Scores ◽  
Prospective Longitudinal

Preterm infants have altered body composition compared to term infants, which impacts both neurodevelopment and metabolic health, but whether increased dietary intake during hospitalization, independent of illness, may improve body composition is unknown. This prospective, longitudinal study (n = 103) measured fat-free mass (FFM) and percent body fat (%BF) at discharge and four months corrected age for prematurity (CA) in very low birth weight (VLBW) preterm infants. Markers of illness and macronutrient intakes (protein and caloric) were recorded. Bayley Scales of Infant Development-III (BSID) were administered at 12 and 24 months of age in a subset of these infants (n = 66 and n = 50 respectively). Body composition z-scores were calculated using recently developed reference curves. Linear regression was used to test the associations between clinical factors and body composition z-scores, as well as z-scores and BSID scores. Increased calories and protein received in the first week after birth and protein intake throughout hospitalization were associated with increased FFM z-scores at discharge, but not with %BF z-scores. After adjustment for both early acute and chronic illness, associations of nutrient intake with FFM z-score remained unchanged. FFM z-scores at discharge were positively associated with scores on the BSID at 12 and 24 months CA. In conclusion, increased energy and protein intakes both early in hospitalization and across its entire duration are associated with higher FFM at discharge, a key marker for organ growth and neurodevelopment in the VLBW neonate. Optimizing caloric intake, irrespective of illness is critical for enhancing body composition, and by extension, neurodevelopmental outcomes for preterm infants.

scholarly journals Impact of size at birth and postnatal growth on metabolic and neurocognitive outcomes in prematurely born school-age children

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoo Jinie Kim ◽  
Seung Han Shin ◽  
Eun Sun Lee ◽  
Young Hwa Jung ◽  
Young Ah Lee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Growth Velocity ◽  
Postnatal Growth ◽  
School Age ◽  
Z Score ◽  
Neurodevelopmental Outcomes ◽  
Neurocognitive Outcomes ◽  
Size At Birth

AbstractPrematurity, size at birth, and postnatal growth are important factors that determine cardiometabolic and neurodevelopmental outcomes later in life. In the present study, we aimed to investigate the associations between the size at birth and growth velocity after birth with cardiometabolic and neurodevelopmental outcomes in preterm infants. Fifty-six preterm infants born at < 32 weeks of gestation or having a birth weight of < 1500 g were enrolled and categorized into small for gestational age (SGA) and appropriate for gestational age (AGA) groups. Anthropometric and cardiometabolic parameters were assessed at school-age, and the Korean Wechsler Intelligence Scale for Children, fourth edition (K-WISC-IV) was used for assessing the intellectual abilities. The growth velocity was calculated by changes in the weight z-score at each time period. Multivariate analysis was conducted to investigate the associations of growth velocity at different periods with cardiometabolic and neurodevelopmental outcomes. Forty-two (75%) were classified as AGA and 25% as SGA. At school-age, despite the SGA children showing significantly lower body weight, lean mass index, and body mass index, there were no differences in the cardiometabolic parameters between SGA and AGA groups. After adjusting for gestational age, birth weight z-score, weight z-score change from birth to discharge and sex, change in weight z-score beyond 12 months were associated with a higher systolic blood pressure, waist circumference, and insulin resistance. Full-scale intelligent quotient (β = 0.314, p = 0.036) and perceptional reasoning index (β = 0.456, p = 0.003) of K-WISC-IV were positively correlated with postnatal weight gain in the neonatal intensive care unit. Although cardiometabolic outcomes were comparable in preterm SGA and AGA infants, the growth velocity at different time periods resulted in different cardiometabolic and neurocognitive outcomes. Thus, ensuring an optimal growth velocity at early neonatal period could promote good neurocognitive outcomes, while adequate growth after 1 year could prevent adverse cardiometabolic outcomes in preterm infants.

scholarly journals New charts for the assessment of body composition, according to air-displacement plethysmography, at birth and across the first 6 mo of life

2019 ◽  
Vol 109 (5) ◽  
pp. 1353-1360 ◽  
Author(s):  
Tom Norris ◽  
Sara E Ramel ◽  
Patrick Catalano ◽  
Carol ni Caoimh ◽  
Paola Roggero ◽  
...  
Keyword(s):  
United States ◽  
Body Composition ◽  
Preterm Infants ◽  
Fat Mass ◽  
Gestational Age ◽  
The United States ◽  
Fat Free Mass ◽  
Term Infants ◽  
Air Displacement Plethysmography ◽  
Young Infants

ABSTRACT Background Air-displacement plethysmography (ADP) is a good candidate for monitoring body composition in newborns and young infants, but reference centile curves are lacking that allow for assessment at birth and across the first 6 mo of life. Objective Using pooled data from 4 studies, we aimed to produce new charts for assessment according to gestational age at birth (30 + 1 to 41 + 6 wk) and postnatal age at measurement (1–27 wk). Methods The sample comprised 222 preterm infants born in the United States who were measured at birth; 1029 term infants born in Ireland who were measured at birth; and 149 term infants born in the United States and 57 term infants born in Italy who were measured at birth, 1 and 2 wk, and 1, 2, 3, 4, 5, and 6 mo of age. Infants whose birth weights were <3rd or >97th centile of the INTERGROWTH-21st standard were excluded, thereby ensuring that the charts depict body composition of infants whose birth weights did not indicate suboptimal fetal growth. Sex-specific centiles for fat mass (kg), fat-free mass (kg), and percentage body fat were estimated using the lambda-mu-sigma (LMS) method. Results For each sex and measure (e.g., fat mass), the new charts comprised 2 panels. The first showed centiles according to gestational age, allowing term infants to be assessed at birth and preterm infants to be monitored until they reached term. The second showed centiles according to postnatal age, allowing all infants to be monitored to age 27 wk. The LMS values underlying the charts were presented, enabling researchers and clinicians to convert measurements to centiles and z scores. Conclusions The new charts provide a single tool for the assessment of body composition, according to ADP, in infants across the first 6 mo of life and will help enhance early-life nutritional management.

Concentrating human milk: an innovative point-of-care device designed to increase human milk feeding options for preterm infants

2020 ◽  
Author(s):  
Elizabeth R. Schinkel ◽  
Elizabeth R. Nelson ◽  
Bridget E. Young ◽  
Robin M. Bernstein ◽  
Sarah N. Taylor ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Point Of Care ◽  
Milk Feeding

Human milk as a protective factor for bronchopulmonary dysplasia: a systematic review and meta-analysis

2018 ◽  
Vol 104 (2) ◽  
pp. F128-F136 ◽  
Author(s):  
Jinglan Huang ◽  
Li Zhang ◽  
Jun Tang ◽  
Jing Shi ◽  
Yi Qu ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Protective Factor ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Current Evidence ◽  
Inclusion Criteria ◽  
Formula Group ◽  
Milk Feeding

ObjectiveTo summarise current evidence evaluating the effects of human milk on the risk of bronchopulmonary dysplasia (BPD) in preterm infants.DesignWe searched for studies on human milk and BPD in English and Chinese databases on 26 July 2017. Furthermore, the references of included studies were also screened. The inclusion criteria in this meta-analysis were the following: (1) preterm infants (<37 weeks); (2) human milk; (3) comparing with formula feeding; (4) the outcome included BPD; and (5) the type of study was randomised controlled trial (RCT) or cohort study.ResultA total of 17 cohort studies and 5 RCTs involving 8661 preterm infants met our inclusion criteria. The ORs and 95% CIs of six groups were as follows: 0.78 (0.68 to 0.88) for exclusive human milk versus exclusive formula group, 0.77 (0.68 to 0.87) for exclusive human milk versus mainly formula group, 0.76 (0.68 to 0.87) for exclusive human milk versus any formula group, 0.78 (0.68 to 0.88) for mainly human milk versus exclusive formula group, 0.83 (0.69 to 0.99) for mainly human milk versus mainly formula group and 0.82 (0.73 to 0.93) for any human milk versus exclusive formula group. Notably, subgroup of RCT alone showed a trend towards protective effect of human milk on BPD but no statistical significance.ConclusionBoth exclusive human milk feeding and partial human milk feeding appear to be associated with lower risk of BPD in preterm infants. The quality of evidence is low. Therefore, more RCTs of this topic are needed.

scholarly journals Carbohydrates in Human Milk and Body Composition of Term Infants during the First 12 Months of Lactation

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1472 ◽  
Author(s):  
Zoya Gridneva ◽  
Alethea Rea ◽  
Wan Jun Tie ◽  
Ching Tat Lai ◽  
Sambavi Kugananthan ◽  
...  
Keyword(s):  
Body Composition ◽  
Human Milk ◽  
Bioelectrical Impedance ◽  
Term Infant ◽  
Fat Free Mass ◽  
Mixed Effects Models ◽  
First Year ◽  
Term Infants ◽  
Total Carbohydrates ◽  
Daily Intakes

Human milk (HM) carbohydrates may affect infant appetite regulation, breastfeeding patterns, and body composition (BC). We investigated relationships between concentrations/calculated daily intakes (CDI) of HM carbohydrates in first year postpartum and maternal/term infant BC, as well as breastfeeding parameters. BC of dyads (n = 20) was determined at 2, 5, 9, and/or 12 months postpartum using ultrasound skinfolds (infants) and bioelectrical impedance spectroscopy (infants/mothers). Breastfeeding frequency, 24-h milk intake and total carbohydrates (TCH) and lactose were measured to calculate HM oligosaccharides (HMO) concentration and CDI of carbohydrates. Statistical analysis used linear regression/mixed effects models; results were adjusted for multiple comparisons. Higher TCH concentrations were associated with greater infant length, weight, fat-free mass (FFM), and FFM index (FFMI), and decreased fat mass (FM), FM index (FMI), %FM and FM/FFM ratio. Higher HMO concentrations were associated with greater infant FFM and FFMI, and decreased FMI, %FM, and FM/FFM ratio. Higher TCH CDI were associated with greater FM, FMI, %FM, and FM/FFM ratio, and decreased infant FFMI. Higher lactose CDI were associated with greater FM, FMI, %FM, and FM/FFM, ratio and decreased FFMI. Concentrations and intakes of HM carbohydrates differentially influence development of infant BC in the first 12 months postpartum, and may potentially influence risk of later obesity via modulation of BC.

Human Milk Feeding Status of Preterm Infants in Neonatal Intensive Care Units in China

2020 ◽  
Vol 36 (2) ◽  
pp. 283-290 ◽  
Author(s):  
Wenjing Peng ◽  
Siyuan Jiang ◽  
Shujuan Li ◽  
Shiwen Xia ◽  
Shushu Chen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Human Milk ◽  
Intensive Care Units ◽  
Preterm Infants ◽  
Significant Variation ◽  
Neonatal Intensive Care ◽  
Current Status ◽  
Neonatal Intensive Care Units ◽  
Feeding Rates ◽  
Milk Feeding

Background Previous low human milk feeding rates in Chinese neonatal intensive care units of preterm infants were reported. There are no nationwide data on these. Research Aims To investigate the current status of human milk feeding for preterm infants in Chinese units and provide baseline data for future research. Methods A secondary data analysis was conducted from a previously established clinical database including 25 Chinese neonatal intensive care units. All infants born <34 weeks gestation and admitted to participating units from May 2015 to April 2018 were enrolled. Variables analyzed were infant data collected and the human milk feeding practices at participating units were surveyed. Results A total of 24,113 infants were included. The overall and exclusive human milk feeding rates were 58.2% and 18.8%, respectively, which increased significantly during study years. We found that rates of human milk feeding decreased with increase in gestational age and birth weight. There was significant variation in human milk feeding rates among units. Most participating Chinese neonatal intensive care units have taken measures to improve the rates of human milk feeding. Conclusions The human milk feeding rates in Chinese neonatal intensive care units have continued to increase in the past 3 years, but there was significant variation among them. More efforts are needed to further increase the human milk feeding rates in China. Trial registration This study was registered NCT02600195 with clinicaltrials.gov on November 9, 2015.

scholarly journals Evidence-Based Methods That Promote Human Milk Feeding of Preterm Infants

2017 ◽  
Vol 44 (1) ◽  
pp. 1-22 ◽  
Author(s):  
Paula P. Meier ◽  
Tricia J. Johnson ◽  
Aloka L. Patel ◽  
Beverly Rossman
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Evidence Based ◽  
Milk Feeding
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