Mother’s own milk dose is associated with decreased time from initiation of feedings to discharge and length of stay in infants with gastroschisis

Storm, Andrew P.; Bowker, Rakhee M.; Klonoski, Samuel C.; Iantorno, Stephanie E.; Shah, Ami N.; Pillai, Srikumar; Bell, Jonathan B.; Patel, Aloka L.

doi:10.1038/s41372-020-0595-3

Cited by 14 publications

(7 citation statements)

References 25 publications

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“…In keeping with our findings of lower rates of formula feeding at NICU discharge in the DM era, previous studies have linked HM, but not DM specifically, to improved outcomes in the gastroschisis and small bowel atresia population [5][6][7][8]. Growth factors such as epidermal growth factor in HM may promote small bowel epithelial growth [25] and gut barrier protection [16]; HM fed infants demonstrate decreased intestinal permeability, which can protect against pathogens in a fragile gut [26].…”

Section: Discussionsupporting

confidence: 81%

“…Human milk (HM), which is most often mother's own milk (MOM), reduces the incidence of NEC in high-risk populations such as infants with preterm birth or gastroschisis [4][5][6]. Additionally, HM has been reported to shorten LOS, PN time and time to full enteral feeds in congenital GI malformations requiring surgery (gastroschisis, atresia) [7,8]. HM also reduces PN time and PN-associated liver disease in infants with short bowel syndrome [9,10] or intestinal failure, which may be a consequence of congenital GI malformations.…”

Section: Introductionmentioning

confidence: 99%

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Supplementation of Mother’s Own Milk with Donor Milk in Infants with Gastroschisis or Intestinal Atresia: A Retrospective Study

et al. 2020

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Background: Mother’s own milk (MOM) improves in-hospital outcomes for preterm infants. If unavailable, donor milk (DM) is often substituted. It is unclear if DM vs. formula to supplement MOM is associated with improved in-hospital outcomes in term/late preterm surgical infants with gastroschisis or intestinal atresia. Methods: This retrospective study included infants born ≥33 weeks gestational age (GA) with a birth weight of >1500 g who were admitted to a quaternary neonatal intensive care unit (NICU). Using Chi square and Mann-Whitney u testing, we compared hospital outcomes (length of stay, parenteral nutrition and central line days) before and after a clinical practice change to offer DM instead of formula in this surgical population. Results: Baseline characteristics were similar between eras for the 140 infants (median GA 37 weeks). Fewer infants in DM era were receiving formula at discharge (50.0% vs. 31.4%, p = 0.03). In sub-analyses including only small bowel atresia and gastroschisis infants, the median length of stay (35 vs. 25, p < 0.01) and the central line days (28 vs. 20, p < 0.01) were lower in the DM era. Conclusion: In this retrospective study, offering DM instead of formula was associated with less formula feeding at discharge, and in infants with gastroschisis or small bowel atresia, shorter length of stay and central line days.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Supplementation of Mother’s Own Milk with Donor Milk in Infants with Gastroschisis or Intestinal Atresia: A Retrospective Study

et al. 2020

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“…However, it is essential to prioritise the indications for its use, to ensure that it meets the needs of VLBW infants and infants born at term or near term with surgical digestive malformations or congenital heart disease. 3,27 Some human milk banks provide donor human milk to supplement mother's own milk when a woman has delivered a health-term baby but has insufficient lactation. It can also be provided exclusively when there is a medical reason why a woman should not breastfeed.…”

Section: What Are the True Needs For Donor H Uman Milk In Neonatal Un...mentioning

confidence: 99%

Review highlights the importance of donor human milk being available for very low birth weight infants

Picaud

2022

Acta Paediatrica

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One of the key roles of neonatal units is to support the growth and development of preterm infants during the critical period between birth and term equivalent age. Nutritional care is an important part in this process, as it is crucial that these vulnerable babies receive sufficient nutrients. Human milk makes a major contribution to this goal. It also has an indirect effect on growth and development, by alleviating the risk of complications due to premature birth. 1 Mother's own milk is the first choice for preterm infants, but some mothers find it difficult to produce and sustain enough milk to meet their infants' needs. A survey of 11 European countries showed that, on average, only 58% of very low birth weight (VLBW) infants received any breast milk at discharge and the rates ranged from 36% to 80%. 2 Donor human milk should be the second choice in such cases, as this provides VLBW infants with essential nutritional and bioactive components. It also minimises their exposure to cows' milk formulas, which have been associated with an increased risk of necrotising enterocolitis (NEC). 3

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“…Associations between HM and shorter length of stay have been demonstrated for preterm infants 25,85 and infants with other surgical anomalies, 18,30,77,86 although results are inconsistent, may be dose dependent, 18,30,86 and may differ between MHM 85 and donor HM. 25 To our knowledge, only one study has examined associations between HM and length of stay for infants with CHD.…”

Section: Length Of Staymentioning

confidence: 99%

Human milk feeding and direct breastfeeding improve outcomes for infants with single ventricle congenital heart disease: Propensity score matched analysis of the NPC-QIC registry

Elgersma

Wolfson

Fulkerson

et al. 2023

Preprint

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Background: Infants with single ventricle (SV) congenital heart disease (CHD) undergo three staged surgeries/interventions, with risk for morbidity and mortality. We estimated the effect of human milk (HM) and direct breastfeeding (BF) on outcomes including necrotizing enterocolitis (NEC), infection-related complications, length of stay (LOS), and mortality. Methods: We analyzed the National Pediatric Cardiology Quality Improvement Collaborative registry (2016?2021), examining HM/BF groups during stage 1 (S1P) and stage 2 (S2P) palliations. We calculated propensity scores for feeding exposures, then fitted Poisson and logistic regression models to compare outcomes between propensity-matched cohorts. Results: Participants included 2491 infants (68 sites). Estimates for all outcomes were better in HM/BF groups. Infants fed exclusive HM before S1P had lower odds of preoperative NEC (OR=0.37, 95% CI=0.17?0.84, p=0.017) and shorter S1P LOS (RR=0.87, 0.78?0.98, p=0.027). During the S1P hospitalization, infants with high HM had lower odds of postoperative NEC (OR=0.28, 0.15?0.50, p<0.001) and sepsis (0.29, 0.13?0.65, p=0.003), and shorter S1P LOS (RR=0.75, 0.66?0.86, p<0.001). At S2P, infants with any HM (0.82, 0.69?0.97, p=0.018) and any BF (0.71, 0.57?0.89, p=0.003) experienced shorter LOS. Conclusions: Infants with SV CHD in high HM and BF groups experienced multiple significantly better outcomes. Given our findings of improved health, strategies to increase the rates of HM/BF in these patients should be implemented. Future research should replicate these findings with granular feeding data and in broader CHD populations, and should examine mechanisms (eg, HM components; microbiome) by which HM/BF benefits these infants.

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Mother’s own milk dose is associated with decreased time from initiation of feedings to discharge and length of stay in infants with gastroschisis

Cited by 14 publications

References 25 publications

Supplementation of Mother’s Own Milk with Donor Milk in Infants with Gastroschisis or Intestinal Atresia: A Retrospective Study

Supplementation of Mother’s Own Milk with Donor Milk in Infants with Gastroschisis or Intestinal Atresia: A Retrospective Study

Review highlights the importance of donor human milk being available for very low birth weight infants

Human milk feeding and direct breastfeeding improve outcomes for infants with single ventricle congenital heart disease: Propensity score matched analysis of the NPC-QIC registry

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