Abstract
Mother’s own milk (MOM) reduces the risk of morbidities in very low birth weight (VLBW) infants. When MOM is unavailable, donor breastmilk (DM) is used, with unclear impact on short- and long-term growth. This retrospective analysis compared anthropometric data at six time points from birth to 20–24 months corrected age in VLBW infants who received MOM supplements of preterm formula (n = 160) versus fortified DM (n = 161) during neonatal intensive care unit (NICU) hospitalization. The cohort was 46% female; mean birth weight and gestational age (GA) were 998 g and 27.3 weeks. Multilevel linear growth models assessed changes in growth z-scores short-term (to NICU discharge) and long-term (post-discharge), controlling for amount of DM or formula received in first 28 days of life, NICU length of stay (LOS), birth GA, and sex. Z-scores for weight and length decreased during hospitalization but increased for all parameters including head circumference post-discharge. Short-term growth was positively associated with LOS and birth GA. A higher preterm formula proportion, but not DM proportion, was associated with slower rates of decline in short-term growth trajectories, but feeding type was unrelated to long-term growth. In conclusion, controlling for total human milk fed, DM did not affect short- or long-term growth.
Highlights
Mother’s own milk (MOM) is the recommended form of nutrition for all infants, for those born preterm, in whom MOM reduces the risk of neonatal morbidities, including necrotizing enterocolitis (NEC), and improves long-term neurodevelopmental outcomes [1,2,3]
The results have been inconsistent, with a recent randomized trial of fortified donor breastmilk (DM) demonstrating no negative impact on short-term growth [9] and a retrospective study demonstrating better short-term weight gain and head circumference (HC) growth with MOM supplemented with fortified DM rather than MOM plus formula [14]
We sought to evaluate the relationship between type of in-neonatal intensive care unit (NICU) enteral feeding, and weight, length, and head circumference (HC) anthropometric z-scores in very low birth weight (VLBW, birth weight
Summary
Mother’s own milk (MOM) is the recommended form of nutrition for all infants, for those born preterm, in whom MOM reduces the risk of neonatal morbidities, including necrotizing enterocolitis (NEC), and improves long-term neurodevelopmental outcomes [1,2,3]. Despite the increasing use of DM in NICUs globally, there is a paucity of studies addressing long-term growth in DM-fed premature infants [7,8,12,15]. We sought to evaluate the relationship between type of in-NICU enteral feeding (proportions of MOM, DM, or preterm formula), and weight, length, and head circumference (HC) anthropometric z-scores in very low birth weight (VLBW, birth weight
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