A clinical study on the effects of extensively hydrolyzed protein formula enteral nutrition of very/extremely low birth weight infants

Abstract

Objective To study the clinical effects of extensively hydrolyzed protein formula (eHPF) and standard preterm infant formula (SPF) in very/extremely low weight (V/ELBW) infants. To provide a theoretical basis for the early feeding of V/ELBW infants. Method From August 2015 to August 2016, V/ELBW infants (gestational age<32 w and birth weight <1 500 g) hospitalized in our neonatal ward were randomly assigned into eHPF group and SPF group. The eHPF group received eHPF feeding from birth to corrected gestational age of 32 weeks, and then fed with SPF; the SPF group was fed with SPF after birth. The clinical data of the two groups were compared including the time needed to regain birth weight, the time needed to achieve total enteral nutrition, the duration of nasogastric tube usage, the complications and blood biochemical indexes. Result A total of 85 cases were included in the eHPF group, and 91 cases in the SPF group.The hospitalization duration, weight increase rate, nasogastric tube duration, the time needed to regain birth weight, the time needed to achieve total enteral nutrition of eHPF group were better than SPF group [(38.4±7.8) d vs. (42.1±11.0) d, (25.5±10.1) g/d vs. (21.8±7.8) g/d, (12.1±4.0) d vs. (16.0±3.8) d, (11.6±3.9) d vs. (13.0±3.8) d, (9.3±2.2) d vs. (14.3±1.8) d], and the differences were statistically significant (P 0.05). Compared with the SPF group, the incidences of cholestasis, NEC and feeding intolerance were lower in the eHPF group (22.7% vs. 24.3%, 6.8% vs. 7.2%, 15.9% vs. 17.1%), and the differences were statistically significant (P 0.05). No significant differences existed on serum total bilirubin level at 7 d after birth between the two groups (P>0.05). Compared with the SPF group, the serum total bilirubin at 14 d was lower in the eHPF group[(40.3±23.0) μmol/L vs. (53.6±26.5) μmol/L], the serum total protein[(50.5±3.7) g/L vs. (46.7±5.3) g/L] and albumin[(31.3±4.1) g/L vs. (29.4±5.2) g/L] at 21 d were higher, the differences were statistically significant (P<0.05). Conclusion eHPF can shorten the time needed to achieve total enteral nutrition and regain birth weight, accelerate the regression of hyperbilirubinemia, reduce the incidences of feeding intolerance and NEC, and it is a safe and effective choice for enteral nutrition in V/ELBW infants. Key words: Infant, extremely low birth weight; Infant, very low birth weight; Enteral nutrition; Infant formula; Extensively hydrolyzed protein formula