Fat supplementation of human milk for promoting growth in preterm infants

Amissah, Emma A; Brown, Julie; Harding, Jane E

doi:10.1002/14651858.cd000341.pub3

Cited by 6 publications

(7 citation statements)

References 47 publications

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“…In particular, protein supplementation to HM increases short-term rates of weight, length, and head circumference gain in preterm infants during hospital admission [ 68 , 71 , 72 ] without a clear evidence of a higher risk of necrotizing enterocolitis or feeding intolerance [ 68 ]. There is insufficient evidence for the effect of fat or carbohydrate supplementation to HM on growth rate [ 73 , 74 ]. In addition, there is some evidence suggesting that HM might protect against metabolic syndrome [ 75 ].…”

Section: Translating Nutritional Research Into Daily Practicementioning

confidence: 99%

Improving long-term health outcomes of preterm infants: how to implement the findings of nutritional intervention studies into daily clinical practice

et al. 2021

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Preterm-born children are at risk for later neurodevelopmental problems and cardiometabolic diseases; early-life growth restriction and suboptimal neonatal nutrition have been recognized as risk factors. Prevention of these long-term sequelae has been the focus of intervention studies. High supplies of protein and energy during the first weeks of life (i.e., energy > 100 kcal kg−1 day−1 and a protein-to-energy ratio > 3 g/100 kcal) were found to improve both early growth and later neurodevelopmental outcome. Discontinuation of this high-energy diet is advised beyond 32–34 weeks postconceptional age to prevent excess fat mass and possible later cardiometabolic diseases. After discharge, nutrition with a higher protein-to-energy ratio (i.e., > 2.5–3.0 g/100 kcal) may improve growth and body composition in the short term.Conclusion: Preterm infants in their first weeks of life require a high-protein high-energy diet, starting shortly after birth. Subsequent adjustments in nutritional composition, aimed at achieving optimal body composition and minimizing the long-term cardiometabolic risks without jeopardizing the developing brain, should be guided by the growth pattern. The long-term impact of this strategy needs to be studied. What is Known:• Preterm infants are at risk for nutritional deficiencies and extrauterine growth restriction.• Extrauterine growth restriction and suboptimal nutrition are risk factors for neurodevelopmental problems and cardiometabolic disease in later life. What is New:• Postnatally, a shorter duration of high-energy nutrition may prevent excess fat mass accretion and its associated cardiometabolic risks and an early switch to a protein-enriched diet should be considered from 32-34 weeks postconceptional age.• In case of formula feeding, re-evaluate the need for the continuation of a protein-enriched diet, based on the infant’s growth pattern.

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Section: Translating Nutritional Research Into Daily Practicementioning

confidence: 99%

Improving long-term health outcomes of preterm infants: how to implement the findings of nutritional intervention studies into daily clinical practice

et al. 2021

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“…These mechanisms are absent in gavage-fed very preterm infants; moreover, nutritional human milk composition is altered by fortifiers. To date, there is no evidence available that macronutrient supplementation of HM improves outcomes of preterm infants [14][15][16]. Differences in HM and multi-nutrient fortifier composition results in variability of nutrient proportions in the fortified milk.…”

Section: Introductionmentioning

confidence: 99%

Impact of Nutrient Intake on Body Composition in Very Low-Birth Weight Infants Following Early Progressive Enteral Feeding

Brinkis,

Albertsson-Wikland,

Šmigelskas

et al. 2024

Nutrients

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Preterm infants have increased body adiposity at term-equivalent age and risk of adverse metabolic outcomes. The aim of the study was to define how nutrient intake may impact body composition (BC) of very low-birth weight infants fed with early progressive enteral feeding and standard fortification. Eighty-six infants with <1500 g birth weight were included in the BC study and stratified into extremely preterm (EP) and very preterm (VP) groups. Nutrient intake was calculated during the first 28 days and BC assessed by dual X-ray absorptiometry at discharge and by skinfold thickness at 12 months of corrected age (CA). Total nutrient intake did not differ between the groups. EP infants had a higher fat mass percentage at discharge than VP infants (24.8% vs. 19.4%, p < 0.001); lean mass did not differ. None of the nutrients had any impact on BC of EP infants. Protein intake did not result in a higher lean mass in either group; fat intake was a significant predictor of increased fat mass percentage in VP infants at discharge (p = 0.007) and body adiposity at 12 months of CA (p = 0.021). Nutritional needs may depend on gestational age and routine fortification should be used with caution in more mature infants.

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“…These mechanisms are absent in gavage fed very preterm infants, moreover, nutritional human milk composition is altered by fortifiers. To date, there is no evidence on ideal supplementation of human milk [14][15][16] and variability of human milk and multi-nutrient fortifier composition results in variability of nutrient composition and proportions in preterm infants. With the increasing awareness of childhood obesity, the goal is to balance between improving neurodevelopment and preventing cardiometabolic consequences later in life.…”

Section: Introductionmentioning

confidence: 99%

Impact of Nutrient Intake on Body Composition in Very Low Birth Weight Infants Following Early Progressive Enteral Feeding

Brinkis,

Albertsson-Wikland,

Šmigelskas

et al. 2024

Preprint

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Fat supplementation of human milk for promoting growth in preterm infants

Abstract: Fat supplementation of human milk for promoting growth in preterm infants (Review)

Cited by 6 publications

References 47 publications

Improving long-term health outcomes of preterm infants: how to implement the findings of nutritional intervention studies into daily clinical practice

Improving long-term health outcomes of preterm infants: how to implement the findings of nutritional intervention studies into daily clinical practice

Impact of Nutrient Intake on Body Composition in Very Low-Birth Weight Infants Following Early Progressive Enteral Feeding

Impact of Nutrient Intake on Body Composition in Very Low Birth Weight Infants Following Early Progressive Enteral Feeding

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