NICU Human Milk Dose and 20-Month Neurodevelopmental Outcome in Very Low Birth Weight Infants

Patra, Kousiki; Hamilton, Matthew J.; Johnson, Tricia J.; Greene, Michelle M.; Dabrowski, Elizabeth; Meier, Paula P.; Patel, Aloka L.

doi:10.1159/000475834

Cited by 68 publications

(58 citation statements)

References 24 publications

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“…The benefits or effect of human milk or DHM on morbidity, specifically necrotising enterocolitis, late onset sepsis, retinopathy of prematurity, bronchopulmonary dysplasia, early achievement of full feeding, encourage successful catch-up growth and neurodevelopment in preterm infants have been well known [ 9 – 11 , 36 , 37 ]. Meanwhile, some studies found that these protective effects showed a time- and dose-dependent relationship [ 38 ]. Therefore, it was still necessary to observe and verify whether there was significant effect on these premature babies when they were provided with such a short time and so little HDM.…”

Section: Discussionmentioning

confidence: 99%

The data and characteristics of the human milk banks in mainland China

et al. 2019

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Background Human milk banks (HMB) have been established for over 100 years in North America and Europe. This study aimed to describe and summarize the operation and characteristics of the HMBs in mainland China since the first nonprofit HMB operated in 2013. Methods Operation of HMB in mainland China is based on the standards and guidelines of the Human Milk Banking Association of North America and some countries in Europe and was modified to meet the needs and circumstances in China such as donation only in the local HMB by medical staff. We reviewed the descriptive data of these 14 HMBs and the clinical characteristics of recipients, the eligible milk donors and the donor milk retrospectively. Results In mainland China, from March 2013 to December 2016, 14 nonprofit HMBs were developed and operational in public hospitals except one and located in the south, east, north and northwest of mainland China. In total, 2680 eligible donors donated 4608.2 L of breast milk. The mean age of these donors was 29.4 years with 60.6% receiving college education and 90.6% term delivery. A total of 4678 recipients including preterm infants ( n = 2990, 63.9%), feeding intolerance ( n = 711, 15.2%), maternal illness ( n = 345, 7.4%), serious infection ( n = 314, 6.7%), necrotising enterocolitis ( n = 244, 5.2%), post-surgery ( n = 38, 0.8%) and others ( n = 36, 0.8%). The rate of discarded raw milk was only 4.4% because of hepatitis B and C or cytomegalovirus positivity. Conclusions HMB has been developing rapidly in mainland China. Donor human milk was used not only for preterm infants but also for other ill children. But the sustainability of milk banking needs proper management and more financial support by relative health authorities and the government.

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Section: Discussionmentioning

confidence: 99%

The data and characteristics of the human milk banks in mainland China

et al. 2019

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“…Feeding with human breast milk rather than formula is the simplest family-centred, valued and effective immunoprotective strategy [49, 50]. Donor breast milk may be beneficial for infants whose mothers cannot provide expressed breast milk, but the cost-effectiveness of this policy remains to be established in some contexts and settings.…”

Section: Resultsmentioning

confidence: 99%

Immunonutrition for Preterm Infants

Walsh

McGuire²

2019

Neonatology

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Care and outcomes for very preterm infants continue to improve, but important causes of mortality and acute and long-term morbidity associated with prolonged hospitalisation remain. Necrotising enterocolitis (NEC) and late-onset infection have emerged as the major causes of death beyond the early neonatal period and of neurodisability in very preterm infants. Although the pathogenesis of these conditions is incompletely understood, it appears to be related to the content and mode of delivery of the enteral diet, particularly the impact of immunonutrients from human breast milk on the microbial and metabolic balance within the immature intestine. Evidence exists to support investment in measures to help mothers to express breast milk as the primary source of nutrition for their very preterm infants. In the absence of maternal milk, pasteurised donor breast milk provides protection against NEC, but its nutritive adequacy is not clear and its cost-effectiveness is uncertain. Supplementation with individual immunonutrients, including immunoglobulins and lactoferrin, has not been shown to be effective in preventing NEC or infection in randomised controlled trials. The evidence base for prebiotics and probiotics is stronger, but concerns exist about the choice, safety and availability of formulations. Other strategies – including avoidance of drugs such as gastric acid suppressants that compromise innate immunity, as well as evidence-based progressive feeding strategies that reduce exposure to invasive interventions – are emerging as key components of care packages to reduce the burden of NEC, infection and associated growth and developmental faltering for very preterm infants.

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“…Of all the parent-delivered interventions, the two most thoroughly studied and powerful interventions that can only be provided by parents are breast milk/breast feeding (Belfort et al, 2016) and skin-to-skin contact, which is also known as the Kangaroo care position. Breast milk and breastfeeding are considered to provide the optimal nutrition for all infants, and to confer immune protection, more appropriate growth, and neurodevelopmental advantage for preterm infants (Patra et al, 2017). Skin-to-skin contact has a multitude of positive effects including supporting infant physiological stability, preventing pain, strongly promoting infant growth and neurobehavioral development, and improving breast feeding (quantity and duration) (Boundy et al, 2016;Holditch-Davis et al, 2014;Johnston et al, 2017;Karimi, Sadeghi, Maleki-Saghooni, & Khadivzadeh, 2019;Lumbanraja, 2016;Nyqvist et al, 2010;Sweeney, Rothstein, Visintainer, Rothstein, & Singh, 2017).…”

Section: Parent-delivered Interventionsmentioning

confidence: 99%

The evolution of family‐centered care: From supporting parent‐delivered interventions to a model of family integrated care

Franck

O’Brien

2019

Birth Defects Research

226

223

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There is increasing recognition that parents play a critical role in promoting the health outcomes of low birthweight and preterm infants. Despite a large body of literature on interventions and models to support family engagement in infant care, parent involvement in the delivery of care for such infants is still restricted in many neonatal intensive care units (NICUs). In this article, we propose a taxonomy for classifying parent‐focused NICU interventions and parent‐partnered care models to aid researchers, clinical teams, and health systems to evaluate existing and future approaches to care. The proposed framework has three levels: interventions to support parents, parent‐delivered interventions, and multidimensional models of NICU care that explicitly incorporate parents and partners in the care of their preterm or low birthweight infant. We briefly review the available evidence for interventions at each level and highlight the strong level of research evidence to support the parent‐delivered intervention of skin‐to‐skin contact (also known as the Kangaroo Care position) and for the Kangaroo mother care and family integrated care models of NICU care. We suggest directions for future research and model implementation to improve and scale‐up parent partnership in the care of NICU infants.

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NICU Human Milk Dose and 20-Month Neurodevelopmental Outcome in Very Low Birth Weight Infants

Cited by 68 publications

References 24 publications

The data and characteristics of the human milk banks in mainland China

The data and characteristics of the human milk banks in mainland China

Immunonutrition for Preterm Infants

The evolution of family‐centered care: From supporting parent‐delivered interventions to a model of family integrated care

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