scholarly journals Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2869
Author(s):  
Ting Ting Fu ◽  
Heather C. Kaplan ◽  
Trayce Fields ◽  
Alonzo T. Folger ◽  
Katelyn Gordon ◽  
...  

Protein content is often inadequate in donor breast milk (DBM), resulting in poor growth. The use of protein-enriched target-pooled DBM (DBM+) has not been examined. We compared three cohorts of very low birth weight (VLBW) infants, born ≤ 1500 g: DBM cohort receiving > 1-week target-pooled DBM (20 kcal/oz), MBM cohort receiving ≤ 1-week DBM, and DBM+ cohort receiving > 1-week DBM+. Infants followed a standardized feeding regimen with additional fortification per clinical discretion. Growth velocities and z-scores were calculated for the first 4 weeks (n = 69 for DBM, 71 for MBM, 70 for DBM+) and at 36 weeks post-menstrual age (n = 58, 64, 59, respectively). In total, 60.8% MBM infants received fortification >24 kcal/oz in the first 30 days vs. 78.3% DBM and 77.1% DBM+. Adjusting for SGA, length velocity was greater with DBM+ than DBM in week 1. Average weight velocity and z-score change were improved with MBM compared to DBM and DBM+, but length z-score decreased similarly across all groups. Incidences of NEC and feeding intolerance were unchanged between eras. Thus, baseline protein enrichment appears safe in stable VLBW infants. Weight gain is greatest with MBM. Linear growth comparable to MBM is achievable with DBM+, though the overall length trajectory remains suboptimal.

1995 ◽  
Vol 28 (3) ◽  
pp. 323-324
Author(s):  
T.R. Fenton ◽  
N. Singhal ◽  
R.D. Baynton ◽  
A.R. Akierman

Transfusion ◽  
2018 ◽  
Vol 58 (12) ◽  
pp. 2894-2902 ◽  
Author(s):  
Yasumi Furui ◽  
Naoji Yamagishi ◽  
Ichiro Morioka ◽  
Rikizo Taira ◽  
Kosuke Nishida ◽  
...  

Author(s):  
Santina A. Zanelli ◽  
Maryam Abubakar ◽  
Robert Andris ◽  
Kavita Patwardhan ◽  
Karen D. Fairchild ◽  
...  

Objective Severe intraventricular hemorrhage (sIVH, grades 3 and 4) is a serious complication for very low birth weight (VLBW) infants and is often clinically silent requiring screening cranial ultrasound (cUS) for detection. Abnormal vital sign (VS) patterns might serve as biomarkers to identify risk or occurrence of sIVH. Study Design This retrospective study was conducted in VLBW infants admitted to two level-IV neonatal intensive care units (NICUs) between January 2009 and December 2018. Inclusion criteria were: birth weight <1.5 kg and gestational age (GA) <32 weeks, at least 12 hours of systemic oxygen saturation from pulse oximetry (SpO2) data over the first 24 hours and cUS imaging. Infants were categorized as early sIVH (sIVH identified in the first 48 hours), late sIVH (sIVH identified after 48 hours and normal imaging in the first 48 hours), and no IVH. Infants with grades 1 and 2 or unknown timing IVH were excluded. Mean heart rate (HR), SpO2, mean arterial blood pressure (MABP), number of episodes of bradycardia (HR < 100 bpm), and desaturation (SpO2 < 80%) were compared. Results A total of 639 infants (mean: 27 weeks' gestation) were included (567 no IVH, 34 early sIVH, and 37 late sIVH). In the first 48 hours, those with sIVH had significantly higher HR compared with those with no IVH. Infants with sIVH also had lower mean SpO2 and MABP and more desaturations <80%. No significant differences in VS patterns were identified in early versus late sIVH. Logistic regression identified higher HR and greater number of desaturations <80% as independently associated with sIVH. Conclusion VLBW infants who develop sIVH demonstrate VS differences with significantly lower SpO2 and higher mean HR over the first 48 hours after birth compared with VLBW infants with no IVH. Abnormalities in early VS patterns may be a useful biomarker for sIVH. Whether VS abnormalities predict or simply reflect sIVH remains to be determined. Key Points


2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yue-feng Li ◽  
Chuan-rui Zhu ◽  
Xue-lei Gong ◽  
Hui-ling Li ◽  
Li-kuan Xiong ◽  
...  

The very low birth weight (VLBW) infant is at great risk for marked dysbiosis of the gut microbiota. In the present study, a total of 36 VLBW infants were randomly divided into two groups, who were treated with combined probiotics and placebo, and 72 fecal specimens on days 14 and 28 of life were collected from them. Finally, 32 fecal specimens extracted from 16 preterm VLBW infants were qualified and analyzed using 16S rRNA gene sequencing. The primary outcome was to evaluate the change of gut microbiota in VLBW infants after combined probiotic supplement. The secondary outcome was to analyze the correlation gut microbial composition and levels of cytokines. We found that probiotic treatment, but not placebo, decreased the α-diversity of gut microbiota in VLBW infants. At the phylum level, probiotic treatment strongly increased the abundance of Firmicutes, whereas that of Proteobacteria was significantly reduced. At the family level, Streptococcaceae and Lactobacillaceae became prevalent after probiotic treatment, while the relative abundance of Enterobacteriaceae was reduced in the meantime. Most notably, significant correlations were observed between Lactobacillaceae abundance and serum cytokine levels. Further studies are required to shed more light on the characteristics of gut microbiota of VLBW neonates. And the modulation of microbiota should be considered to improve the survival rate of VLBW infants.


Author(s):  
S.H. Elbeely ◽  
M.A. AlQurashi

BACKGROUND: Very low birth weight infants born prematurely are at greater risk for growth delays that lead to Ex-utero Growth Restriction (EUGR) during vulnerable periods of organ structural and functional development. There is considerable evidence that early growth failure has adverse effects on long term neurodevelopment in children which often persists into adulthood. METHODS: This is a single-center cross-sectional study on live newborn infants with birth weight ranges from 500 to 1500 grams (VLBW) and gestational age (GA) between 24–32 weeks who were admitted to NICU at KAMC-Jeddah over a 5 year period (2009–2013). This study aims to evaluate predischarge growth pattern of VLBW infants in terms of weight, head circumference (HC) and length and to identify important variables that have influenced such growth pattern. RESULTS: Of the 135 infants included in the final analysis, 68 (50.4%) were male and 67 (49.6%) were female and the mean gestational age was 28.83±2.064 weeks and the mean birth weight 1166.74±256 grams. Ninety-two infants (68%) had discharge weight at ≤10th percentile and forty four (32%) had their weight >10th percentile. HC was the lowest affected among the anthropometric measurements with 42% ≤10th percentile. In terms of linear growth, 62% had their length ≤10th percentile. Amongst infants born ≤750 grams, 71% and 70% had HC and height at ≤10th percentile respectively, at the time of discharge. BPD was significantly associated with EUGR (p = 0.026). CONCLUSIONS: This study demonstrates that almost 2/3rd of VLBW infants born at KAMC-Jeddah with birth weight ≤750 grams were discharged home with EUGR as demonstrated by their weight, length, and HC ≤10th percentile. BPD was found to be significantly associated with EUGR amongst post-natal factors influencing EUGR.


2012 ◽  
Vol 12 (4) ◽  
pp. 254-259 ◽  
Author(s):  
Leslie A. Parker ◽  
Charlene Krueger ◽  
Sandra Sullivan ◽  
Teresa Kelechi ◽  
Martina Mueller

2017 ◽  
Vol 34 (14) ◽  
pp. 1389-1395 ◽  
Author(s):  
Coleen Greecher ◽  
Kim Doheny ◽  
Kristen Glass

Aim Oropharyngeal administration of colostrum (OAC) has been proposed to provide mother's early milk to very low-birth-weight (VLBW) infants in the first few days of life. The aim of this study was to test the hypothesis that OAC would increase salivary secretory IgA (SsIgA). Patients and Methods Overall, 30 VLBW infants randomized to receive OAC or sterile water had salivary sampling for SsIgA on the day of life (DOL) 2, 7, and 14. The incidence of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) was determined prospectively. Within and between-group comparisons were made by paired and independent samples t-tests. Results Baseline characteristics were similar between groups. SsIgA was higher in OAC versus the control group (p < 0.05) on DOL 7, but not subsequently on DOL 14. There was no difference in LOS or NEC. Conclusion OAC increased SsIgA at DOL 7. A large, multicenter trial is needed to determine if OAC decreases LOS or NEC in VLBW infants.


2020 ◽  
Vol 148 (1-2) ◽  
pp. 52-57
Author(s):  
Gordana Vilotijevic-Dautovic ◽  
Aleksandra Doronjski ◽  
Gordana Vijatov-Djuric ◽  
Milena Bjelica

Introduction/Objective. The incidence of bronchopulmonary dysplasia (BPD) varies depending on the prematurity rate, definition, and therapy that are applied at a certain center. The average incidence of BPD for very low birth weight infants (VLBW) in developed countries ranges 4?53%. The mortality of VLBW infants is high and represents 50% of the total neonatal and infant mortality. In recent years, the survival limits are shifted towards lower gestations. The aim of our study was to determine the incidence and severity of BPD in VLBW infants in Vojvodina and the overall mortality. Methods. This retrospective study was conducted from January 2006 to December 2011 and included 504 infants with birth weight < 1,500 g. Results. In the total premature infants? population, 82.3% survived by the gestational age of 36 weeks. According to the original definition of BPD, as supplemental oxygen use at 28 days of life, BPD had 45.4% of infants. According to the severity based definition 19.4% had mild BPD, 19.8% moderate BPD and 6.5% severe BPD. If BPD is observed as supplemental oxygen use at 36 weeks postmenstrual age, BPD had 26% of infants. Conclusion. The overall mortality and incidence of BPD in our study are comparable to those in some developed countries and lower compared to underdeveloped countries.


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