Outcomes improved with human milk intake in preterm and full-term infants

Chetta, Katherine E.; Schulz, Elizabeth V.; Wagner, Carol L.

doi:10.1016/j.semperi.2020.151384

Cited by 21 publications

(19 citation statements)

References 117 publications

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“…Third, we have no information on breast milk or formula intake. We are aware that breast milk plays an important role in brain development [56,57]. Although we do not expect a difference in breast milk intake between cohort A and B, as there was no change in protocols regarding the use of breast milk, this cannot be completely ruled out.…”

Section: Limitationsmentioning

confidence: 87%

Nutritional Intake, White Matter Integrity, and Neurodevelopment in Extremely Preterm Born Infants

et al. 2021

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Background: Determining optimal nutritional regimens in extremely preterm infants remains challenging. This study aimed to evaluate the effect of a new nutritional regimen and individual macronutrient intake on white matter integrity and neurodevelopmental outcome. Methods: Two retrospective cohorts of extremely preterm infants (gestational age <28 weeks) were included. Cohort B (n = 79) received a new nutritional regimen, with more rapidly increased, higher protein intake compared to cohort A (n = 99). Individual protein, lipid, and caloric intakes were calculated for the first 28 postnatal days. Diffusion tensor imaging was performed at term-equivalent age, and cognitive and motor development were evaluated at 2 years corrected age (CA) (Bayley-III-NL) and 5.9 years chronological age (WPPSI-III-NL, MABC-2-NL). Results: Compared to cohort A, infants in cohort B had significantly higher protein intake (3.4 g/kg/day vs. 2.7 g/kg/day) and higher fractional anisotropy (FA) in several white matter tracts but lower motor scores at 2 years CA (mean (SD) 103 (12) vs. 109 (12)). Higher protein intake was associated with higher FA and lower motor scores at 2 years CA (B = −6.7, p = 0.001). However, motor scores at 2 years CA were still within the normal range and differences were not sustained at 5.9 years. There were no significant associations with lipid or caloric intake. Conclusion: In extremely preterm born infants, postnatal protein intake seems important for white matter development but does not necessarily improve long-term cognitive and motor development.

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Section: Limitationsmentioning

confidence: 87%

Nutritional Intake, White Matter Integrity, and Neurodevelopment in Extremely Preterm Born Infants

et al. 2021

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“…In einem kürzlich erschienenen Review-Artikel werden die Auswirkungen von Muttermilch und humaner Spendermilch verglichen. Darin konnte auch für Spendermilch eine Reduktion des NEK- und BPD-Risikos nachgewiesen werden, nicht jedoch für Sepsis oder ROP 21 .…”

Section: Therapiestrategien Zur Ernährung Frühgeborener Während Der I...unclassified

Postnatale Ernährung bei sehr kleinen Frühgeborenen

Petersen¹,

Nomayo²,

Jochum³

2022

Neonatologie Scan

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“…Breast milk is also known to have positive immunomodulatory and psychological effects and reduces the risk of developing many diseases like respiratory tract infections and allergic diseases (9,10). Preterm infants fed breast milk during hospitalization in neonatal intensive care units (NICUs) have a lower risk of developing infections and necrotizing enterocolitis (4,(11)(12)(13)(14)(15)(16)(17)(18). However, for preterm infants to reach intrauterine growth rates (19), in general higher amounts of nutrients are needed, which cannot be obtained solely from native breast milk [Figure 1] (1).…”

Section: Introductionmentioning

confidence: 99%

Individualized Target Fortification of Breast Milk: Optimizing Macronutrient Content Using Different Fortifiers and Approaches

Fusch

Yousuf

et al. 2021

Front. Nutr.

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Background: Native breast milk composition displays significant inter- and intra-individual variation which persists after standard fortification with fixed doses and challenges target fortification. This study aims to analyze the macronutrient composition of different commercially available fortifiers and the effect of different fortification strategies on nutritional intake of preterm infants.Methods: In 103 preterm infants, native breast milk samples were collected from 24-h feeding batches (n = 3,338) and fat, protein and carbohydrate contents were analyzed. Nutrient content was compared for breast milk that had undergone either (i) standard fortification, (ii) targeted fortification, (iii) selective batching according to breast milk composition, or (iv) partial lyophilization. For (i) eight commercially available standard fortifiers were tested. Targeted fortification (ii) involved the addition of single component modulars of either protein, fat or carbohydrates to standard fortified breast milk. Using a mathematical growth model, the combined effect of protein, fat and carbohydrate intake on growth was assessed. The best composition of standard fortifiers as the initial step for target fortification was explored assuming three clinical scenarios for milk analysis.Results: Macronutrient content was highly variable between native breast milk samples, and this variation was still present after standard fortification, however at elevated macronutrient levels. Standard fortification, breast milk batching, as well as partial lyophilization of human milk resulted in deficient and imbalanced enteral intakes in a significant proportion of infants. Target fortification reduced this variation in a, respectively, higher percentage of samples. The effect size was dependent on the number of measurements per week. The optimum composition of standard fortifiers was dependent on the clinical scenario (measurement frequency) for target fortification.Conclusions: To provide precise and accurate intakes of macronutrients, breast milk should be target fortified. Standard fortified breast milk can result in excess above recommended intakes of some macronutrients which limits the efficiency of target fortification. Standard fortifiers with improved composition are needed for target fortification.

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Outcomes improved with human milk intake in preterm and full-term infants

Cited by 21 publications

References 117 publications

Nutritional Intake, White Matter Integrity, and Neurodevelopment in Extremely Preterm Born Infants

Nutritional Intake, White Matter Integrity, and Neurodevelopment in Extremely Preterm Born Infants

Postnatale Ernährung bei sehr kleinen Frühgeborenen

Individualized Target Fortification of Breast Milk: Optimizing Macronutrient Content Using Different Fortifiers and Approaches

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