Preterm Infants Fed Cow's Milk-Derived Fortifier Had Adverse Outcomes Despite a Base Diet of Only Mother's Own Milk

Lucas, Alan; Boscardin, John; Abrams, Steven A.

doi:10.1089/bfm.2019.0133

Cited by 34 publications

(36 citation statements)

References 39 publications

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“…Begner et al (2020) [29], in a pilot study, demonstrated that PT infants fed on exclusive HBM do not show in time severe cognitive developmental delay and present favorable growth and body composition. Differently, PT infants feed on IF show an increase in adverse outcomes respect to the use of HBM [30]. It is possible that it may be due to the presence of other nutrients specific for the brain in HBM.…”

Section: Relevance Of Fatty Acids In Human Breast Milkmentioning

confidence: 98%

Relationship between Fatty Acids Composition/Antioxidant Potential of Breast Milk and Maternal Diet: Comparison with Infant Formulas

et al. 2020

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The fatty acid composition of human breast milk is relevant for the energy, immunity and eicosanoid production in infants. Additionally, the antioxidant properties of foods are essential for human health. Therefore, in the present study we aimed to investigate the relationship between maternal diet and fatty acids composition as well as the antioxidant potential of breast milk from donors to human milk bank of Perugia’s hospital, Italy. Results were compared with infant formulas. We observed increased levels of total fatty acids and, in particular, saturated and monounsaturated fatty acids in milk from mothers fed on a vegetable and fruit-rich diet compared with a Mediterranean diet. In the same milk, a reduced antioxidant potential was found. All infant formulas resulted in richer total fatty acid content than human breast milk. Only some formulas were qualitatively similar to breast milk. Of note, the antioxidant potential of the formulas was higher or lower than the human milk with the exception of one sample. The antioxidant potential of four formulas was very high. Dietary supplementation with antioxidants has been shown to have a teratogenic effect and to increase the formation of metastases in adult. There are no data on the effects of excess antioxidants in the infants, but the possibility that they can be harmful cannot be excluded.

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Section: Relevance Of Fatty Acids In Human Breast Milkmentioning

confidence: 98%

Relationship between Fatty Acids Composition/Antioxidant Potential of Breast Milk and Maternal Diet: Comparison with Infant Formulas

et al. 2020

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“…A post hoc subgroup analysis of infants not receiving preterm formula (n=114) showed a 4.2-fold increased risk of NEC and a 5.1-fold increased risk of NEC surgery or death in infants receiving a cow's milk-based, as opposed to a human milk-based, fortifier. 28 In a Canadian randomised controlled trial, on human milk-based vs cow's milk-based nutrient fortifier in 127 preterm infants with a birth weight <1250 g, the infants were exclusively fed with breast milk. 31 The primary outcome, feeding tolerance, was similar in the two study groups.…”

Section: Open Accessmentioning

confidence: 99%

Nordic study on human milk fortification in extremely preterm infants: a randomised controlled trial—the N-forte trial

et al. 2021

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IntroductionThe mortality rate of extremely low gestational age (ELGA) (born <gestational week 28+0) infants remains high, and severe infections and necrotising enterocolitis (NEC) are common causes of death. Preterm infants receiving human milk have lower incidence of sepsis and NEC than those fed a bovine milk-based preterm formula. Despite this, fully human milk fed ELGA infants most often have a significant intake of cow’s milk protein from bovine-based protein fortifier. The aim of this study is to evaluate whether the supplementation of human milk-based, as compared with bovine-based, nutrient fortifier reduces the prevalence of NEC, sepsis and mortality in ELGA infants exclusively fed with human milk.Methods and analysisA randomised-controlled multicentre trial comparing the effect of a human breast milk-based fortifier with a standard bovine protein-based fortifier in 222–322 ELGA infants fed human breast milk (mother’s own milk and/or donor milk). The infants will be randomised to either fortifier before reaching 100 mL/kg/day in oral feeds. The intervention, stratified by centre, will continue until the target postmenstrual week 34+0. The primary outcome is a composite of NEC, sepsis or death. Infants are characterised with comprehensive clinical and nutritional data collected prospectively from birth until hospital discharge. Stool, urine, blood and breast milk samples are collected for analyses in order to study underlying mechanisms. A follow-up focusing on neurological development and growth will be performed at 2 and 5.5 years of age. Health economic analyses will be made.Ethics and disseminationThe study is conducted according to ICH/GCP guidelines and is approved by the regional ethical review board in Linköping Sweden (Dnr 2018/193-31, Dnr 2018/384-32). Results will be presented at scientific meetings and published in peer-reviewed publications.Trial registration numberThe study was registered with ClinicalTrials.gov NCT03797157, 9 January 2019.

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“…That care often includes the use of human donor milk and human donor milk-derived products, including fortifiers. (13,35) When analyzing studies, several questions must be asked:…”

Section: It Is Not Appropriate To Extrapolate Data From Pasteurized Human Milk Studies To Human Milk Sterilized By a Different Processmentioning

confidence: 99%

“…Data demonstrate a 77% reduction in NEC and meaningful reductions in many other common comorbidities (Sepsis, ROP, BPD, along with feeding intolerance, TPN, and length of stay). (13,14)…”

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confidence: 99%

The Importance of Data in an Exclusive Human Milk Diet: Key Concepts and Points of Consideration

Goldstein

2021

Neonatology Today

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Data is a term that is not hard to define but is difficult to describe. We recognize data for what it is but fail to understand how to interpret it. In the interest of qualifying data and preserving effort, more rigorous challenges to data are often put aside to qualify or validate the effort." "Lack of statistical power may lead to incorrect conclusions, but overpowered studies may invariably find a "statistically" significant finding with no clinical utility. (12)" 69 NEONATOLOGY TODAYtwww.NeonatologyToday.nettSeptember 2021 Disclosures: There are no relevant disclosures identified.

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Preterm Infants Fed Cow's Milk-Derived Fortifier Had Adverse Outcomes Despite a Base Diet of Only Mother's Own Milk

Cited by 34 publications

References 39 publications

Relationship between Fatty Acids Composition/Antioxidant Potential of Breast Milk and Maternal Diet: Comparison with Infant Formulas

Relationship between Fatty Acids Composition/Antioxidant Potential of Breast Milk and Maternal Diet: Comparison with Infant Formulas

Nordic study on human milk fortification in extremely preterm infants: a randomised controlled trial—the N-forte trial

The Importance of Data in an Exclusive Human Milk Diet: Key Concepts and Points of Consideration

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