Abstract
Breastfeeding has been recommended for preterm infants as the optimal diet from nutritional, gastrointestinal, immunological, and developmental perspectives. However, the relevance of differing intakes of fortified mother’s own milk (MOM) on the growth of their preterm infants is a challenging question because of the potential risk of extrauterine growth impairment, apart from its essential role in the provision of biological and immunological factors, and the reduction of serious morbidities. We aimed to identify the weight gain pattern in very-preterm-born infants with respect to their proportional intake of fortified MOM. The daily and average weight gain, dietary volume, calories, and proportional intake of fortified MOM were studied in a cohort of 84 very-preterm-born infants during the first 2 weeks post initiation of full enteral feeds. Groups 1, 2, and 3 were comprised of infants with a proportional fortified MOM intake of 85% or more, 35% to 84.9%, and 0 to 34.9%, respectively. Data analysis included regression models and a group-based comparison of the number of infants with weight gain that would be considered minimally acceptable for normal intrauterine growth. The infants’ weight gain was not found to be associated with the proportional intake of fortified MOM or other feeding parameters. Overall, the intergroup variability in the proportion of infants with weight gain less than the lower limit of normal fetal growth was insignificant. During the first 2 weeks post initiation of full enteral feeds, the weight gain pattern of the studied very-preterm-born infants was not significantly dependent on the proportional intake of fortified maternal milk.
Highlights
Nutritional vulnerability due to inadequate nutrient stores at birth, and metabolic as well as gastrointestinal immaturity [1,2,3], are major factors that affect the growth and development of preterm infants during birth hospitalization and during childhood and adult life [4,5,6,7].The American Academy of Pediatrics (AAP) recommends that maternal milk should be the primary food for prematurely born infants [8] because of its nutritional and its gastrointestinal, immunological, and developmental advantages [9,10,11]
We identified the infant’s weight gain pattern over the first 2 weeks of full enteral feedings with respect to the type of feeding that was defined as (i) predominantly breast fed if the average of the fortified mother’s own milk (MOM) in the infant’s diet during the study period was 85% or more (Group1); (ii) partially breast fed if the average of the MOM
The effect of human milk fortification on the weight gain pattern of preterm infants is reportedly small [24], one possible explanation for our findings is that the fortification of MOM may have enabled achievement of a caloric intake that was similar to preterm formula
Summary
Nutritional vulnerability due to inadequate nutrient stores at birth, and metabolic as well as gastrointestinal immaturity [1,2,3], are major factors that affect the growth and development of preterm infants during birth hospitalization and during childhood and adult life [4,5,6,7].The American Academy of Pediatrics (AAP) recommends that maternal milk should be the primary food for prematurely born infants [8] because of its nutritional and its gastrointestinal, immunological, and developmental advantages [9,10,11]. Nutritional vulnerability due to inadequate nutrient stores at birth, and metabolic as well as gastrointestinal immaturity [1,2,3], are major factors that affect the growth and development of preterm infants during birth hospitalization and during childhood and adult life [4,5,6,7]. The nutritional value of exclusive feeding with human milk is questioned despite the fortification that has been used for the achievement of appropriate protein uptake and the growth of very- or extremely-preterm-born infants [12]. A higher rate of short-term growth in formula-fed preterm neonates versus those fed donor human milk has been reported [13]. A precise quantitative measure of the intake of maternal milk by the preterm infant is required for the identification of valid data regarding the relationship between breastfeeding and related outcomes [14]. The World Health Organization (WHO) suggests defining the proportional intake of mother’s own milk (MOM) as an indicator value for exclusive breastfeeding [15]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call