Abstract
Objective:
The objective of this study is to determine whether the use of donor human milk (DHM) in very low birth weight (VLBW, ⩽1500 g) neonates in a large neonatal intensive care unit (NICU) affected the rate of necrotizing enterocolitis (NEC) or impacted growth.
Study Design:
This was a retrospective chart review of 550 VLBW neonates following the introduction of DHM as the preferred diet if maternal breast milk (MBM) was not available. Demographics, growth parameters, incidence of NEC or death and days of DHM or MBM were extracted from charts.
Result:
Compared with infants who received human milk (HM) on fewer than 50% of hospital days, neonates who received HM on ⩾50% of hospital days had equivalent growth outcomes but lower rates of NEC (NEC 3.4 vs 13.5%, P<0.001) and mortality (1.0 vs 4.2%, P=0.017). Growth and NEC rates were inversely correlated with the duration of exposure to HM.
Conclusion:
HM should always be the diet of choice in preterm infants. DHM is a safe alternative, if MBM is not available. Although the use of HM is associated with lower rates of NEC, growth rates were significantly lower in infants with significant HM intake. The decline in growth rates following the introduction of DHM should draw attention to optimize fortification of all HM feedings.
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References
Hair AB, Hawthorne KM, Chetta KE, Abrams SA . Human milk feeding supports adequate growth in infants </= 1250 grams birth weight. BMC Res Notes 2013; 6: 459.
Latal-Hajnal B, von Siebenthal K, Kovari H, Bucher HU, Largo RH . Postnatal growth in VLBW infants: significant association with neurodevelopmental outcome. J Pediatr 2003; 143 (2): 163–170.
Ehrenkranz RA, Dusick AM, Vohr BR, Wright LL, Wrage LA, Poole WK . Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatrics 2006; 117 (4): 1253–1261.
Neu J, Walker WA . Necrotizing enterocolitis. N Engl J Med 2011; 364 (3): 255–264.
Sullivan S, Schanler RJ, Kim JH, Patel AL, Trawoger R, Kiechl-Kohlendorfer U et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr 2010; 156 (4): 562–567.e561.
Kelley L . Increasing the consumption of breast milk in low-birth-weight infants: can it have an impact on necrotizing enterocolitis? Adv Neonatal Care 2012; 12 (5): 267–272.
Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012; 129 (3): e827–e841.
Radmacher PG, Lewis SL, Adamkin DH . Individualizing fortification of human milk using real time human milk analysis. J Neonatal Perinatal Med 2013; 6 (4): 319–323.
De Curtis M, Rigo J . The nutrition of preterm infants. Early Hum Dev 88: S5–S7.
Agostoni C, Buonocore G, Carnielli VP, De Curtis M, Darmaun D, Decsi T et al. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2010; 50 (1): 85–91.
American Academy of Pediatrics Committee on Nutrition, Kleinman RE, Greer FR . Pediatric Nutrition. American Academy of Pediatrics: Elk Grove Village, IL, 2013.
Fanaro S . Which is the ideal target for preterm growth? Minerva Pediatr 2010; 62 (3 Suppl 1): 77–82.
Senterre T, Rigo J . Optimizing early nutritional support based on recent recommendations in VLBW infants and postnatal growth restriction. J Pediatr Gastroenterol Nutr 2011; 53 (5): 536–542.
Fenton TR, Kim JH . A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatrics 2013; 13: 59.
Patel AL, Engstrom JL, Meier PP, Kimura RE . Accuracy of methods for calculating postnatal growth velocity for extremely low birth weight infants. Pediatrics 2005; 116 (6): 1466–1473.
Patel AL, Engstrom JL, Meier PP, Jegier BJ, Kimura RE . Calculating postnatal growth velocity in very low birth weight (VLBW) premature infants. J Perinatol 2009; 29 (9): 618–622.
Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 1978; 187 (1): 1–7.
Kliegman RM, Walsh MC . Neonatal necrotizing enterocolitis: pathogenesis, classification, and spectrum of illness. Curr Probl Pediatr 1987; 17 (4): 219–288.
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Chowning, R., Radmacher, P., Lewis, S. et al. A retrospective analysis of the effect of human milk on prevention of necrotizing enterocolitis and postnatal growth. J Perinatol 36, 221–224 (2016). https://doi.org/10.1038/jp.2015.179
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DOI: https://doi.org/10.1038/jp.2015.179
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