Alyahya W.a,b· Simpson J.c· Garcia A.L.a· Mactier H.d· Young D.e· Edwards C.A.a

Author affiliations

aDepartment of Human Nutrition, School of Medicine, Dentistry and Nursing, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
bDepartment of Clinical Nutrition, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
cNeonatal Unit, Royal Hospital for Children, Glasgow, UK
dNeonatal Unit, Princess Royal Maternity, Glasgow, UK
eDepartment of Mathematics and Statistics, University of Strathclyde, Glasgow, UK

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Article / Publication Details

First-Page Preview

Received: June 05, 2022
Accepted: October 05, 2022
Published online: January 05, 2023

Number of Print Pages: 10
Number of Figures: 2
Number of Tables: 4

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

Abstract

Objective: Mother’s own milk (MOM) is the optimal feed for premature infants but may not always be sufficiently available. Alternative feeding includes donor human milk (DONOR), with or without fortification and preterm formula. This study evaluated the association between early feeding with exclusively and predominantly MOM (MAINLY-MOM) versus MOM supplemented with fortified DONOR (MOM + DONOR) or preterm formula (MOM + FORMULA) and in-hospital growth and neonatal morbidities. Method: This was a multicentre (n = 13 units) cohort study of infants born at <32 weeks’ gestation. Data captured at the point of care were extracted from the UK National Neonatal Research Database. The study groups were defined based on feeding patterns within the first 2 weeks of life using predefined cut-offs. The primary outcome was the in-hospital growth rate. Results: Data from 1,272 infants were analysed. Infants fell into two groups: extremely preterm (EPT) infants and very preterm (VPT) infants, born after <28 weeks and 28 to <32 weeks of gestation, respectively. Only 11 of 365 EPT infants received formula supplements, precluding a useful comparison of MOM + DONOR and MOM + FORMULA. There was no difference in median (25th–75th centile) growth velocity over the first 30 days of life between the MAINLY-MOM (n = 248) and MOM + DONOR (n = 106) groups: 10 (8–13) versus 10 (7–13) g/kg/day. Similarly, for VPT infants, there was no difference in growth velocities between MAINLY-MOM (n = 407), MOM + DONOR (N = 196), and MOM + FORMULA (N = 304): 11 (8–14) versus 11 (8–14) versus 11 (8–14) g/kg/day. Head growth did not differ (p value = 0.670). Cox regression analysis showed no difference in time to discharge between feeding types or any difference in major neonatal morbidities. In both EPT and VPT infants, growth velocity from the time of regaining birth weight to discharge was significantly lower in the MAINLY-MOM group compared to the MOM-DONOR group (EPT: 12.5 [11–14.2] vs. 14 [12.3–15.9] p = 0.45, VPT 13.5 [11–15.7] vs. 14.5 [12.6–16.8] p = 0.015). Conclusion: Early feeding with fortified DONOR, in comparison to formula, to supplement MOM was not associated with any differences in short-term growth, length of stay, and neonatal morbidities. However, early feeding with mainly maternal milk, compared to maternal milk supplemented with DONOR, was associated with significantly lower overall weight gain.

© 2023 S. Karger AG, Basel

References Quigley M, Embleton ND, McGuire W. Formula versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev. 2019;(7):CD002971. Angelsen NK, Vik T, Jacobsen G, Bakketeig L. Breast feeding and cognitive development at age 1 and 5 years. Arch Dis Child. 2001;85(3):183–8. Curtis MD, Rigo J. Extrauterine growth restriction in very-low-birthweight infants. Acta Paediatr. 2004;93(12):1563–8. Ehrenkranz RA, Das A, Wrage LA, Poindexter BB, Higgins RD, Stoll BJ, et al. Early nutrition mediates the influence of severity of illness on extremely LBW infants. Pediatr Res. 2011;69(6):522–9. Corpeleijn WE, Kouwenhoven SMP, Paap MC, van Vliet I, Scheerder I, Muizer Y, et al. Intake of own mother’s milk during the first days of life is associated with decreased morbidity and mortality in very low birth weight infants during the first 60 Days of life. Neonatology. 2012;102(4):276–81. Daniels SCM, Daniels S, Corkins M, de Ferranti S, Golden NH, Kim JH, et al. Donor human milk for the high-risk infant: preparation, safety, and usage options in the United States. Pediatrics. 2017;139(1):e20163440. Klingenberg C, Embleton ND, Jacobs SE, O’Connell LAF, Kuschel CA. Enteral feeding practices in very preterm infants: an international survey. Arch Dis Child Fetal Neonatal Ed. 2012 January;97(1):F56–61. Alyahya W, Barnett D, Cooper A, Garcia AL, Edwards CA, Young D, et al. Donated human milk use and subsequent feeding pattern in neonatal units. Int Breastfeed J. 2019;14(1):39. National Institute for Health and Care Excellence. Donor milk banks: service operation. 2010. [cited 2022 19/09]. Available from: https://www.nice.org.uk/guidance/cg93. National Institute for Health and Care Excellence. Neonatal parenteral nutrition 2022. cited 2022 19/09]. Available from: https://www.nice.org.uk/guidance/qs205/resources/neonatal-parenteral-nutrition-pdf-75547416105925. Weisman LE, Stoll BJ, Kueser TJ, Rubio TT, Frank CG, Heiman HS, et al. Intravenous immune globulin prophylaxis of late-onset sepsis in premature neonates. J Pediatr. 1994;125(6):922–30. Davies DP. Adequacy of expressed breast milk for early gwoth of preterm infants. Arch Dis Child. 1977;52(4):296–301. Behrman RE, Tyson JE, Lasky RE, Mize CE, Richards CJ, Blair-Smith N, et al. Growth, metabolic response, and development in very-low-birth-weight infants fed banked human milk or enriched formula. I. Neonatal findings. J Pediatr. 1983;103(1):95–104. Cooper PA, Rothberg AD, Pettifor JM, Bolton KD, Devenhuis S. Growth and biochemical response of premature infants fed pooled preterm milk or special formula. J Pediatr Gastroenterol Nutr. 1984 Nov;3(5):749–54. Lucas A, Gore SM, Cole TJ, Bamford MF, Dossetor JF, Barr I, et al. Multicentre trial on feeding low birthweight infants: effects of diet on early growth. Arch Dis Child. 1984;59(8):722–30. Ginovart G, Gich I, Gutiérrez A, Verd S. A fortified donor milk policy is associated with improved in-hospital head growth and weight gain in very low-birth-weight infants. Adv Neonatal Care. 2017;17(4):250–7. Lambeth T, Rojas M, Auringer S, Lightbourne T, Barahona M, Anthony E. Necrotizing enterocolitis and growth in preterm infants fed predominantly maternal milk, pasteurized donor milk, or preterm formula: a retrospective study. Am J Perinatol. 2016;34(07):676–83. Schanler RJ, Lau C, Hurst NM, Smith EO. Randomized trial of donor human milk versus preterm formula as substitutes for mother’s own milk in the feeding of extremely premature infants. Pediatrics. 2005;116(2):400–6. Cristofalo EA, Schanler RJ, Blanco CL, Sullivan S, Trawoeger R, Kiechl-Kohlendorfer U, et al. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. J Pediatr. 2013;163(6):1592–5. e1. Verd S, Porta R, Botet F, Gutiérrez A, Ginovart G, Barbero AH, et al. Hospital outcomes of extremely low birth weight infants after introduction of donor milk to supplement mother’s milk. Breastfeed Med. 2015;10(3):150–5. Madore LS, Bora S, Erdei C, Jumani T, Dengos AR, Sen S. Effects of donor breastmilk feeding on growth and early neurodevelopmental outcomes in preterm infants: an observational study. Clin Ther. 2017;39(6):1210–20. O’Connor DL, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, et al. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA. 2016;316(18):1897–905. Bray PF, Shields WD, Wolcott GJ, Madsen JA. Occipitofrontal head circumference: an accurate measure of intracranial volume. J Pediatr. 1969;75(2):303–5. Thureen PJ. The neonatologist’s dilemma: catch-up growth or beneficial undernutrition in very low birth weight infants: what are optimal growth rates? J Pediatr Gastroenterol Nutr. 2007;45(Suppl 3):S152–4. Corpeleijn WE, Kouwenhoven SM, van Goudoever JB. Optimal growth of preterm infants. Nutrition and Growth: Karger Publishers; 2013. p. 149–55. Ehrenkranz RA, Dusick AM, Vohr BR, Wright LL, Wrage LA, Poole WK, et al. Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatrics. 2006;117(4):1253–61. Kurzner SI, Garg M, Bautista DB, Bader D, Merritt RJ, Warburton D, et al. Growth failure in infants with bronchopulmonary dysplasia: nutrition and elevated resting metabolic expenditure. Pediatrics. 1988;81(3):379–84. Corpeleijn WE, De Waard M, Christmann V, van Goudoever JB, Jansen-van der Weide MC, Kooi EMW, et al. Effect of donor milk on severe infections and mortality in very low-birth-weight infants: the early nutrition study randomized clinical trial. JAMA Pediatr. 2016;170(7):654–61. Alyahya W, Simpson J, Garcia AL, Mactier H, Edwards CA. Early versus delayed fortification of human milk in preterm infants: a systematic review. Neonatology. 2020;117(1):24–32. Article / Publication Details

First-Page Preview

Received: June 05, 2022
Accepted: October 05, 2022
Published online: January 05, 2023

Number of Print Pages: 10
Number of Figures: 2
Number of Tables: 4

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

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