Comparison of Calorie and Protein Intake of Very Low Birth Weight Infants Receiving Mother's Own Milk or Donor Milk When the Nutrient Composition of Human Milk Is Measured With a Breast Milk Analyzer

Newkirk, Melanie; Shakeel, Fauzia; Parimi, Prabhu S.; Rothpletz‐Puglia, Pamela; Patusco, Rachael; Marcus, Andrea Fleisch; Brody, Rebecca

doi:10.1002/ncp.10060

Cited by 10 publications

(6 citation statements)

References 29 publications

(63 reference statements)

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“…Given reports of inferior growth with DM [4,7,10,11,12,13] and concerns regarding low protein content [23], our feeding protocol supplemented all DM with protein in addition to standard fortification, regardless of infant growth. Although we did not analyze milk samples, this protein supplementation presumably increased the nutritional content of DM and may explain the lack of effect of DM on short-term growth [30], providing additional evidence to support this widely-used practice for DM. Similar to the DoMINO trial [9], the majority of infant feedings in both groups consisted of MOM, even when excluding infants fed exclusive MOM, thus limiting our ability to study the effects of high-dose DM.…”

Section: Discussionmentioning

confidence: 99%

Impact of Donor Milk on Short- and Long-Term Growth of Very Low Birth Weight Infants

et al. 2019

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Mother’s own milk (MOM) reduces the risk of morbidities in very low birth weight (VLBW) infants. When MOM is unavailable, donor breastmilk (DM) is used, with unclear impact on short- and long-term growth. This retrospective analysis compared anthropometric data at six time points from birth to 20–24 months corrected age in VLBW infants who received MOM supplements of preterm formula (n = 160) versus fortified DM (n = 161) during neonatal intensive care unit (NICU) hospitalization. The cohort was 46% female; mean birth weight and gestational age (GA) were 998 g and 27.3 weeks. Multilevel linear growth models assessed changes in growth z-scores short-term (to NICU discharge) and long-term (post-discharge), controlling for amount of DM or formula received in first 28 days of life, NICU length of stay (LOS), birth GA, and sex. Z-scores for weight and length decreased during hospitalization but increased for all parameters including head circumference post-discharge. Short-term growth was positively associated with LOS and birth GA. A higher preterm formula proportion, but not DM proportion, was associated with slower rates of decline in short-term growth trajectories, but feeding type was unrelated to long-term growth. In conclusion, controlling for total human milk fed, DM did not affect short- or long-term growth.

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Section: Discussionmentioning

confidence: 99%

Impact of Donor Milk on Short- and Long-Term Growth of Very Low Birth Weight Infants

et al. 2019

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“…In fact, the mean protein content decreases during lactation, while the nutrient needs of VLBW infants remain high ( 28 , 29 ). In addition, although it has been reported that donor human milk provides nutrients comparable to mother's milk, preterm infants fed donor human milk fortified similarly to fresh mother's milk according to standard methods showed an increased risk of postnatal growth restriction ( 30 , 31 ). In contrast, it has been reported that fortification of donor human milk to reach 3.5 g/kg of protein intake is associated with significantly greater weight gain and head growth in VLBW infants than feeding a formula-based diet ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, although it has been reported that donor human milk provides nutrients comparable to mother's milk, preterm infants fed donor human milk fortified similarly to fresh mother's milk according to standard methods showed an increased risk of postnatal growth restriction ( 30 , 31 ). In contrast, it has been reported that fortification of donor human milk to reach 3.5 g/kg of protein intake is associated with significantly greater weight gain and head growth in VLBW infants than feeding a formula-based diet ( 30 ). In addition, targeted fortification of human milk seems to represent an optimal strategy to prevent postnatal growth restriction ( 32 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Human Milk on Modulating the Quality of Growth in Preterm Infants

et al. 2018

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Introduction: Human milk is the optimal nutrition for preterm infants. When the mother's own milk is unavailable, donor human milk is recommended as an alternative for preterm infants. The association among early nutrition, body composition and the future risk of disease has recently attracted much interest. The aim of this study was to investigate the effect of human milk on the body composition of preterm infants.Materials and Methods: Very low birth weight infants (VLBW: birth weight <1,500 g) with a gestational age (GA) between 26 and 34 weeks were included. Clinical data, anthropometric measurements and nutritional intake in terms of the volume of human milk were extracted from computerized medical charts. The human milk intake was expressed as a percentage of target fortified donor human milk and/or target fortified fresh mother's milk, compared with the total volume of milk intake during the hospital stay. All included infants underwent anthropometric measurements and body composition analysis (expressed as fat-free mass percentage) at term corrected age (CA) by air-displacement plethysmography. A comparison between infants fed human milk at <50% (group 1) and infants fed human milk at ≥50% of the total volume of milk intake (group 2) was conducted. Multiple linear regression analyses were conducted to explore the modulating effect of fortified human milk on fat-free mass at term CA.Results: Seventy-three VLBW infants were included in the study. The mean weight and GA at birth were 1,248 ± 198 g and 30.2 ± 2.0 weeks, respectively. No differences were found regarding anthropometric measurements at birth, at discharge and at term CA between the two groups. The mean fortified human milk intake was 34.9 ± 12.5 and 80.9 ± 15.5% in groups 1 and 2, respectively (p < 0.001).A multiple regression analysis corrected for sex and birth weight demonstrated that intake of ≥50% fortified human milk was associated with a higher fat-free mass percentage at term CA than intake of <50% fortified human milk.Conclusion: The use of target fortified human milk modulated growth and improved growth quality in vulnerable preterm infants. Thus, the use of donor human milk should be encouraged when fresh mother's milk is insufficient or not available.

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“…Based on our observations, we have submitted recommendations to the neonatal clinical guideline development group to consider the lower dose of CC at 5 mg/kg (elemental caffeine of 2.5 mg/kg) as the standard starting maintenance dose and to appropriately incorporate additional nutritional input or consideration if ELBW and VLBW infants are maintained on a relatively higher dose of caffeine for prolonged periods. 39 A reaudit is recommended for the audit cycle completion in 2019.…”

Section: Discussionmentioning

confidence: 99%

Caffeine Treatment for Apnea of Prematurity and the Influence on Dose-Dependent Postnatal Weight Gain Observed Over 15 Years

Philip

Ismail

Murphy

et al. 2018

Journal of Caffeine and Adenosine Research

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Background and Aim: To analyze the influence on weight gain of infants exposed to two dosage regimens of oral caffeine citrate (CC) for apnea of prematurity.Methods: Retrospective descriptive observational study of an eligible very low birth weight cohort over a 15-year period in an Irish University hospital. Data were analyzed between two distinct postnatal ages: 14–28 and 29–56 days.Results: During the 15-year study, 457 infants were prescribed caffeine. Among the 14–28-day group, after applying exclusion criteria, 418 infants qualified. Two hundred forty-eight infants received 5 mg/(kg·day) and 170 received 10 mg/(kg·day) of CC. Among the 29–56-day group, 362 infants were identified and after applying exclusions, 332 fulfilled entry criteria [214 on 5 mg/(kg·day) and 118 on 10 mg/(kg·day) regimen]. Baseline characteristics of infants were comparable between groups without statistically significant differences. Mean daily weight gain (MDWG) in grams from day 14 to 28 showed a higher rate of increase for the 5 mg/(kg·day) group compared with the 10 mg/(kg·day) group (17.2 ± 12 g vs. 13.0 ± 10.2 g [p = 0.04]). From day 29 to 56, also MDWG was higher among infants on 5 mg/(kg·day) of CC compared with 10 mg/(kg·day) group (15.6 ± 10.8 g vs. 10.2 ± 9.8 g [p = 0.011]).Conclusion: While a variety of measures are optimized to promote postnatal weight gain of premature infants close to an ideal intrauterine growth curve, not paying sufficient attention to one of the most widely used catabolic agents in neonatology is questionable and warrants vigilance. Additional nutritional measures could be offered to those with prolonged caffeine exposure.

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Comparison of Calorie and Protein Intake of Very Low Birth Weight Infants Receiving Mother's Own Milk or Donor Milk When the Nutrient Composition of Human Milk Is Measured With a Breast Milk Analyzer

Abstract: DBM provides comparable nutrient intake to MOM at a higher enteral feeding volume. However, both types of human milk failed to meet energy needs with standard fortification regimens.

Cited by 10 publications

References 29 publications

Impact of Donor Milk on Short- and Long-Term Growth of Very Low Birth Weight Infants

Impact of Donor Milk on Short- and Long-Term Growth of Very Low Birth Weight Infants

The Effect of Human Milk on Modulating the Quality of Growth in Preterm Infants

Caffeine Treatment for Apnea of Prematurity and the Influence on Dose-Dependent Postnatal Weight Gain Observed Over 15 Years

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