Growth of Very Low Birth Weight Infants on Varying Amounts of Human Milk Protein

Polberger, Staffan; Axelsson, Inge; Räihä, Niels C. R.

doi:10.1203/00006450-198904000-00022

Cited by 117 publications

(68 citation statements)

References 26 publications

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“…9 Infants in both fortifier groups demonstrated acceptable mean achieved weights, lengths, and head circumferences across the study period. Total enteral and parenteral energy intakes in both groups approximated the 504 kJ/kg per day considered by Polberger et al 8 to be required for optimum growth. Infants who received HMF-T had significantly greater mean total protein intake than did those who received HMF-C.…”

Section: Growthmentioning

confidence: 93%

“…1 Several investigators [5][6][7][8] have recently expressed concerns that premature infants, especially those who weigh Ͻ1000 g, need increased caloric intakes, especially that provided by protein. Growth failure among many of the smaller infants in these studies was attributable to failure to ingest recommended dietary intakes parenterally 5 and/or enterally 6-8 for protein and calories.…”

Section: Growthmentioning

confidence: 99%

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Growth, Efficacy, and Safety of Feeding an Iron-Fortified Human Milk Fortifier

et al. 2004

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ABSTRACT. Objective. Survival rates for preterm infants who weigh between 501 and 1500 g at birth have continued to improve over time. In response to this continuing decrease in birth weight of surviving preterm infants, Enfamil Human Milk Fortifier has recently been reformulated to meet the nutritional requirements of these smaller, more rapidly growing infants. It now provides an increased protein level of 1.1 g/58 kJ, a decreased carbohydrate level of 0.2 g/58 kJ, and a combined linoleic and ␣-linolenic fatty acid content of 157 mg/58 kJ. As these very small preterm infants have an increased requirement for dietary iron, the fortifier has been supplemented with 1.44 mg/58 kJ of iron, an amount of iron similar to that provided in a typical iron-fortified term infant formula. An iron-fortified product obviates the need for administration of an iron supplement, a hyperosmolar-inducing intervention. The purpose of this prospective, double-blind, randomized, controlled study was to evaluate growth, safety, and efficacy in a population of very low birth weight (VLBW) preterm infants who received human milk fortified with either the reformulated iron-fortified powdered human milk fortifier test product (HMF-T) or a powdered commercially available human milk fortifier control product (HMF-C).Methods. Infants who weighed <1500 g, had a gestational age <33 weeks postmenstrual age, and had an enteral intake of at least 100 mL/kg per day of unfortified human milk were stratified by gender and birth weight and randomized to receive HMF-T or HMF-C product from study day 1 to study day 28, hospital discharge, or the termination of human milk feedings, whichever came first. Unless medically indicated, investigators were not to administer iron supplements from study days 1 to 14. Infants were assessed serially for growth; enteral and parenteral intake; serum chemistry and hematologic values; clinical histories, including the administration of blood transfusions; feeding tolerance; respiratory outcomes; and morbidities, including adverse events.Results. Of the 181 participating infants in this study, 96 received HMF-T and 85 received HMF-C. At randomization, there were no significant differences in infant characteristics between the fortifier groups. The percentage of participants who remained in the study for 28 days was similar between fortifier groups (57% HMF-T, 46% HMF-C). For both fortifier groups, the most frequent reasons for discontinuing the study before study day 28 were unavailability of human milk and hospital discharge. Rate of weight gain was similar between the fortifier groups (17.5 ؎ 0.53 g/kg per day for HMF-T and 17.3 ؎ 0.59 g/kg per day for HMF-C). Mean achieved weight, length, and head circumference were comparable between groups across the 28-day study period. Total protein intake from enteral and parenteral nutrition was significantly greater for the HMF-T fortifier group; however, this difference did not result in any difference in growth between the 2 fortifier groups. An analysis of the growth and en...

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Section: Growthmentioning

confidence: 93%

Section: Growthmentioning

confidence: 99%

Growth, Efficacy, and Safety of Feeding an Iron-Fortified Human Milk Fortifier

et al. 2004

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“…2,[12][13][14] However, the longer that infants stay in hospital the greater the obstacles preventing mothers from participating in the daily care of their children. In these situations the nutritional option for preterms, in this study, was banked donor human milk.…”

Section: Discussionmentioning

confidence: 99%

“…Weight gain was satisfactory, but below what has been reported in other studies into nutritional strategies for preterms, primarily when fed with their own mothers milk or preterm formula, 14 which may be a result of methodological differences, including age at start and duration of the studies and type of milk and supplements. 12,14,[16][17][18][19] Several different studies of the use of fortified human milk have evaluated biochemical parameters and shown them to be normal. Nevertheless, the parameters evaluated are basically restricted to calcium, phosphorous, alkaline phosphatase and urea.…”

Section: S1 -Dhmmentioning

confidence: 99%

Fração de excreção de sódio, osmolaridade e densidade urinária em recém-nascidos prematuros alimentados com leite humano de banco adicionado de suplemento

Tanaka¹,

Rugolo²,

Miranda³

et al. 2006

J. Pediatr. (Rio J.)

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Objective: This research was performed with the objective of investigating the renal effects on premature newborn infants of fortifying banked donor human milk.Methods: Clinical intervention trial, of the before-and-after type, involving 28 premature newborn infants split into two groups by postconceptional age at the start of the study: GI < 34 weeks (n = 14) and GII ≥ 34 weeks (n = 14), and assessed at three sample points: S1, on unfortified donor human milk, S2, after 3 days, and S3, after 10-13 days on fortified donor human milk. Nutrient intake, weight gain, fractional sodium excretion, urinary osmolality and specific density were compared with two-way ANOVA for repeated measures.Results: Fluids, energy and sodium intakes were similar for both groups, and weight gain was satisfactory. Among the preterms with < 34 weeks postconceptional age, serum sodium was lower at the end of the study and the fractional sodium excretion was elevated at the start and at the end of the study (S1 = 2.11±1.05; S2 = 1.25±0.64; S3 = 1.62±0.88), with a significant difference in relation to GII (S1 = 1.34±0.94; S2 = 0.90±0.54; S3 = 0.91±0.82). Osmolality and urinary specific density were normal, with no differences between groups or collection dates. Conclusions:No adverse effects on the renal function of these preterms were detected as a result of being fed fortified donor human milk. Fractional sodium excretion, urinary osmolality and specific gravity in preterm infants fed with fortified donor human milk

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“…Dieta com suplemento na forma líquida irá fornecer 2,7 g/100 kcal (grupo I); com suplemento em pó, fornece 3,4 g/100 kcal; e com suplemento comercial, 2,4 g/100 kcal. Todas fornecem quantidade dentro da referência para nutrição de RNMBP e recém-nascido de extremo baixo peso (RNEBP) [18][19][20] . A oferta de 160 mL/kg/dia de leite humano aditivado com suplemento homólogo em pó (grupo II) irá fornecer ao RNMBP 3,8 g/kg/dia de proteína homóloga, atendendo às necessidades nutricionais dessa população com menor risco à saúde em longo prazo 2,3 .…”

Section: Figura 1 -unclassified

Comparison between homologous human milk supplements and a commercial supplement for very low birth weight infants

et al. 2012

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Objectives: To describe the methodology for the preparation of two additives derived from human milk, liquid and powdered, and to compare this composition with the commercial additive FM85 ® . Methods:For the preparation of the liquid and powdered supplements, 40 samples of human milk were used. Both supplements have been through three preparation phases: skimming, evaporation and lactose removal. After these phases, the liquid supplement is ready, and the powdered requires a fourth phase -lyophilization. To each sample of the liquid and powdered supplements were added, respectively, 80 mL (group I) and 100 mL (group II) of pooled banked human milk. For comparison, 20 samples of 100 mL of the pool were added to 5 g of the FM85 ® supplement (Nestlé) (group III). Analyses of carbohydrates, protein, lipids, calcium, phosphorus, sodium, osmolality and caloric content were performed, considering a significant difference p < 0.05. Results Conclusion:The studied additives differ significantly from the commercial additive FM85 ® in some of its components, and its composition may or may not meet the quantity of nutrients suggested by the most recent recommendations. J Pediatr (Rio J). 2012;88(2):119-24:Premature infant, enteral nutrition, human milk, milk bank. ResumoObjetivos: Descrever a metodologia de preparo de dois aditivos, líquido e em pó, derivados do leite humano e comparar a constituição com aditivo comercial FM85 ® . Métodos:Foram utilizadas 40 amostras de leite humano para o preparo dos suplementos líquido e em pó. Ambos passaram por três fases de preparo: desnate, evaporação e retirada da lactose. Após essas fases, o suplemento líquido está pronto, e o em pó necessita da quarta fase -a liofilização. Em cada amostra dos suplementos líquido e em pó, foram adicionados, respectivamente, 80 mL (grupo I) e 100 mL (grupo II) de pool de leite humano de banco. Para comparação, 20 amostras de 100 mL do pool foram acrescidas de 5 g do suplemento FM85 ® (Nestlé) (grupo III). Realizaram-se análises de hidratos de carbono, proteína, lipídios, cálcio, fósforo, sódio, osmolalidade e conteúdo calórico, considerando diferença significativa p < 0,05. Conclusão:Os aditivos estudados diferem significativamente do aditivo comercial FM85 ® em alguns de seus constituintes, e a sua constituição pode ou não atender às quantidades de nutrientes propostas pelas recomendações mais recentes. J Pediatr (Rio J)

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Growth of Very Low Birth Weight Infants on Varying Amounts of Human Milk Protein

Cited by 117 publications

References 26 publications

Growth, Efficacy, and Safety of Feeding an Iron-Fortified Human Milk Fortifier

Growth, Efficacy, and Safety of Feeding an Iron-Fortified Human Milk Fortifier

Fração de excreção de sódio, osmolaridade e densidade urinária em recém-nascidos prematuros alimentados com leite humano de banco adicionado de suplemento

Comparison between homologous human milk supplements and a commercial supplement for very low birth weight infants

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