Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of Feed Intolerance
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Agostoni, C.; Buonocore, G.; Carnielli, V.P.; De Curtis, M.; Darmaun, D.; Decsi, T.; Domellöf, M.; Embleton, N.D.; Fusch, C.; 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, 85–91. [Google Scholar] [CrossRef] [PubMed]
- Eidelman, A.I. Breastfeeding and the use of human milk: An analysis of the American Academy of Pediatrics 2012 Breastfeeding Policy Statement. Breastfeed Med. 2012, 7, 323–324. [Google Scholar] [CrossRef] [PubMed]
- ESPGHAN Committee on Nutrition; Agostoni, C.; Braegger, C.; Decsi, T.; Kolacek, S.; Koletzko, B.; Michaelsen, K.F.; Mihatsch, W.; Moreno, L.A.; Puntis, J.; et al. Breast-feeding: A commentary by the ESPGHAN Committee on Nutrition. J. Pediatr. Gastroenterol. Nutr. 2009, 49, 112–125. [Google Scholar] [CrossRef] [PubMed]
- Lucas, A.; Cole, T.J. Breast milk and neonatal necrotising enterocolitis. Lancet 1990, 336, 1519–1523. [Google Scholar] [CrossRef]
- Lucas, A.; Morley, R.; Cole, T.J.; Lister, G.; Leeson-Payne, C. Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992, 339, 261–264. [Google Scholar] [CrossRef]
- McGuire, W.; Anthony, M.Y. Donor human milk versus formula for preventing necrotising enterocolitis in preterm infants: Systematic review. Arch. Dis. Child. Fetal Neonatal Ed. 2003, 88, 11–14. [Google Scholar] [CrossRef]
- Sisk, P.M.; Lovelady, C.A.; Dillard, R.G.; Gruber, K.J.; O’Shea, T.M. Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants. J Perinatol. 2007, 27, 428–433. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bauer, J.; Gerss, J. Longitudinal analysis of macronutrients and minerals in human milk produced by mothers of preterm infants. Clin. Nutr. 2011, 30, 215–220. [Google Scholar] [CrossRef] [PubMed]
- Arslanoglu, S.; Moro, G.E.; Ziegler, E.E.; The Wapm Working Group on Nutrition, null. Optimization of human milk fortification for preterm infants: New concepts and recommendations. J. Perinat. Med. 2010, 38, 233–238. [Google Scholar] [CrossRef] [PubMed]
- Hawthorne, K.M.; Abrams, S.A. Safety and efficacy of human milk fortification for very-low-birthweight infants. Nutr. Rev. 2004, 62, 482–485. [Google Scholar] [CrossRef] [PubMed]
- Kuschel, C.A.; Harding, J.E. Multicomponent fortified human milk for promoting growth in preterm infants. Cochrane. Database Syst. Rev. 2004. [Google Scholar] [CrossRef]
- Maggio, L.; Costa, S.; Gallini, F. Human milk fortifiers in very low birth weight infants. Early Hum. Dev. 2009, 85, S59–S61. [Google Scholar] [CrossRef] [PubMed]
- Brown, J.V.E.; Embleton, N.D.; Harding, J.E.; McGuire, W. Multi-nutrient fortification of human milk for preterm infants. Cochrane. Database Syst. Rev. 2016. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Schanler, R.J. Suitability of human milk for the low-birthweight infant. Clin. Perinatol. 1995, 22, 207–222. [Google Scholar] [CrossRef]
- Schanler, R.J.; Abrams, S.A. Postnatal attainment of intrauterine macromineral accretion rates in low birth weight infants fed fortified human milk. J. Pediatr. 1995, 126, 441–447. [Google Scholar] [CrossRef]
- Arslanoglu, S.; Bertino, E.; Coscia, A.; Tonetto, P.; Giuliani, F.; Moro, G.E. Update of adjustable fortification regimen for preterm infants: A new protocol. J. Biol. Regul. Homeost. Agents 2012, 26, 65–67. [Google Scholar] [PubMed]
- Arslanoglu, S.; Moro, G.E.; Ziegler, E.E. Adjustable fortification of human milk fed to preterm infants: Does it make a difference? J. Perinatol. 2006, 26, 614–621. [Google Scholar] [CrossRef] [PubMed]
- Sullivan, S.; Schanler, R.J.; Kim, J.H.; Patel, A.L.; Trawöger, R.; Kiechl-Kohlendorfer, U.; Chan, G.M.; Blanco, C.L.; Abrams, S.; Cotten, C.M.; 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, 562–567. [Google Scholar] [CrossRef] [PubMed]
- Pearson, F.; Johnson, M.J.; Leaf, A.A. Milk osmolality: Does it matter? Arch. Dis. Child. Fetal Neonatal Ed. 2013, 98, 166–169. [Google Scholar] [CrossRef] [PubMed]
- Goldblum, O.M.; Holzman, I.R.; Fisher, S.E. Intragastric feeding in the neonatal dog. Its effect on intestinal osmolality. Am. J. Dis. Child. 1981, 135, 631–633. [Google Scholar] [CrossRef] [PubMed]
- Schmid, H.R.; Ehrlein, H.J. Effects of enteral infusion of hypertonic saline and nutrients on canine jejunal motor patterns. Dig. Dis. Sci. 1993, 38, 1062–1072. [Google Scholar] [CrossRef] [PubMed]
- Srinivasan, L.; Bokiniec, R.; King, C.; Weaver, G.; Edwards, A.D. Increased osmolality of breast milk with therapeutic additives. Arch. Dis. Child. Fetal Neonatal Ed. 2004, 89, F514–F517. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Palcich, G.; de Moraes Gillio, C.; Aragon-Alegro, L.C.; Pagotto, F.J.; Farber, J.M.; Landgraf, M.; Destro, M.T. Enterobacter sakazakii in dried infant formulas and milk kitchens of maternity wards in São Paulo, Brazil. J. Food Prot. 2009, 72, 37–42. [Google Scholar] [CrossRef] [PubMed]
- Stanger, J.; Zwicker, K.; Albersheim, S.; Murphy, J.J. Human milk fortifier: An occult cause of bowel obstruction in extremely premature neonates. J. Pediatr. Surg. 2014, 49, 724–726. [Google Scholar] [CrossRef] [PubMed]
- Flikweert, E.R.; La Hei, E.R.; De Rijke, Y.B.; Van de Ven, K. Return of the milk curd syndrome. Pediatr. Surg. Int. 2003, 19, 628–631. [Google Scholar] [CrossRef] [PubMed]
- Murase, M.; Miyazawa, T.; Taki, M.; Sakurai, M.; Miura, F.; Mizuno, K.; Itabashi, K.; Toki, A. Development of fatty acid calcium stone ileus after initiation of human milk fortifier. Pediatr. Int. 2013, 55, 114–116. [Google Scholar] [CrossRef] [PubMed]
- Willeitner, A.; Anderson, M.; Lewis, J. Highly Concentrated Preterm Formula as an Alternative to Powdered Human Milk Fortifier: A Randomized Controlled Trial. J. Pediatr. Gastroenterol. Nutr. 2017, 65, 574–578. [Google Scholar] [CrossRef] [PubMed]
- Tsang, R.C.; Uauy, R.; Koletzko, B.; Zlotkin, S. Nutrition of the Preterm Infant: Scientific Basis and Practical Guidelines; Digital Educational Publishing, Inc.: Cincinnati, OH, USA, 2005. [Google Scholar]
- Boyce, C.; Watson, M.; Lazidis, G.; Reeve, S.; Dods, K.; Simmer, K.; McLeod, G. Preterm human milk composition: A systematic literature review. Br. J. Nutr. 2016, 116, 1033–1045. [Google Scholar] [CrossRef] [PubMed]
- Gidrewicz, D.A.; Fenton, T.R. A systematic review and meta-analysis of the nutrient content of preterm and term breast milk. BMC Pediatr. 2014, 14, 216. [Google Scholar] [CrossRef] [PubMed]
- Fenton, T.R. A new growth chart for preterm babies: Babson and Benda’s chart updated with recent data and a new format. BMC Pediatr 2003, 3, 13. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fenton, T.R.; Kim, J.H. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr. 2013, 13, 59. [Google Scholar] [CrossRef] [PubMed]
- Fenton, T.R.; Sauve, R.S. Using the LMS method to calculate z-scores for the Fenton preterm infant growth chart. Eur. J. Clin. Nutr. 2007, 61, 1380–1385. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Patel, A.L.; Engstrom, J.L.; Meier, P.P.; Kimura, R.E. Accuracy of methods for calculating postnatal growth velocity for extremely low birth weight infants. Pediatrics 2005, 116, 1466–1473. [Google Scholar] [CrossRef] [PubMed]
- Patel, A.L.; Engstrom, J.L.; Meier, P.P.; Jegier, B.J.; Kimura, R.E. Calculating postnatal growth velocity in very low birth weight (VLBW) premature infants. J. Perinatol. 2009, 29, 618–622. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bell, M.J.; Ternberg, J.L.; Feigin, R.D.; Keating, J.P.; Marshall, R.; Barton, L.; Brotherton, T. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann. Surg. 1978, 187, 1–7. [Google Scholar] [CrossRef] [PubMed]
- Ehrenkranz, R.A.; Walsh, M.C.; Vohr, B.R.; Jobe, A.H.; Wright, L.L.; Fanaroff, A.A.; Wrage, L.A.; Poole, K. National Institutes of Child Health and Human Development Neonatal Research Network Validation of the National Institutes of Health consensus definition of bronchopulmonary dysplasia. Pediatrics 2005, 116, 1353–1360. [Google Scholar] [CrossRef] [PubMed]
- International Committee for the Classification of Retinopathy of Prematurity The International Classification of Retinopathy of Prematurity revisited. Arch. Ophthalmol. 2005, 123, 991–999. [CrossRef] [PubMed]
- Abdallah, E.A.A.; Said, R.N.; Mosallam, D.S.; Moawad, E.M.I.; Kamal, N.M.; Fathallah, M.G.E.-D. Serial serum alkaline phosphatase as an early biomarker for osteopenia of prematurity. Medicine (Baltimore) 2016, 95, e4837. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kim, J.H.; Chan, G.; Schanler, R.; Groh-Wargo, S.; Bloom, B.; Dimmit, R.; Williams, L.; Baggs, G.; Barrett-Reis, B. Growth and tolerance of preterm infants fed a new extensively hydrolyzed liquid human milk fortifier. J. Pediatr. Gastroenterol. Nutr. 2015, 61, 665–671. [Google Scholar] [CrossRef] [PubMed]
- Fanaro, S. Feeding intolerance in the preterm infant. Early Hum. Dev. 2013, 89 (Suppl. 2), S13–S20. [Google Scholar] [CrossRef]
- Thoene, M.; Lyden, E.; Weishaar, K.; Elliott, E.; Wu, R.; White, K.; Timm, H.; Anderson-Berry, A. Comparison of a powdered, acidified liquid, and non-acidified liquid human milk fortifier on clinical outcomes in premature infants. Nutrients 2016, 8, 451. [Google Scholar] [CrossRef] [PubMed]
- Mukhopadhyay, K.; Narnag, A.; Mahajan, R. Effect of human milk fortification in appropriate for gestation and small for gestation preterm babies: A randomized controlled trial. Indian Pediatr. 2007, 44, 286–290. [Google Scholar] [PubMed]
- Villar, J.; Giuliani, F.; Barros, F.; Roggero, P.; Coronado Zarco, I.A.; Rego, M.A.S.; Ochieng, R.; Gianni, M.L.; Rao, S.; Lambert, A.; et al. Monitoring the postnatal growth of preterm infants: A paradigm change. Pediatrics 2018, 141. [Google Scholar] [CrossRef] [PubMed]
- Moya, F.; Sisk, P.M.; Walsh, K.R.; Berseth, C.L. A new liquid human milk fortifier and linear growth in preterm infants. Pediatrics 2012, 130, e928–e935. [Google Scholar] [CrossRef] [PubMed]
- Hintz, S.R.; Kendrick, D.E.; Stoll, B.J.; Vohr, B.R.; Fanaroff, A.A.; Donovan, E.F.; Poole, W.K.; Blakely, M.L.; Wright, L.; Higgins, R.; et al. Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis. Pediatrics 2005, 115, 696–703. [Google Scholar] [CrossRef] [PubMed]
- Nicholl, R.M.; Gamsu, H.R. Changes in growth and metabolism in very low birthweight infants fed with fortified breast milk. Acta. Paediatr. 1999, 88, 1056–1061. [Google Scholar] [CrossRef] [PubMed]
- Ehrenkranz, R.A.; Dusick, A.M.; Vohr, B.R.; Wright, L.L.; Wrage, L.A.; Poole, W.K. Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatrics 2006, 117, 1253–1261. [Google Scholar] [CrossRef] [PubMed]
- Erickson, T.; Gill, G.; Chan, G.M. The effects of acidification on human milk’s cellular and nutritional content. J. Perinatol. 2013, 33, 371–373. [Google Scholar] [CrossRef] [PubMed]
- Thoene, M.; Hanson, C.; Lyden, E.; Dugick, L.; Ruybal, L.; Anderson-Berry, A. Comparison of the effect of two human milk fortifiers on clinical outcomes in premature infants. Nutrients 2014, 6, 261–275. [Google Scholar] [CrossRef] [PubMed]
- Manz, F.; Kalhoff, H.; Remer, T. Renal acid excretion in early infancy. Pediatr. Nephrol. 1997, 11, 231–243. [Google Scholar] [CrossRef] [PubMed]
24 kcal/oz Fortified Preterm Human Milk * | ||
---|---|---|
Per 100 mL | Powder HMF | CPF |
Dilution/Mixing | 4 packets to 100 mL HM | 40 mL CPF with 60 mL HM |
Calories | 81 | 81 |
Protein | 2.6 | 2.1 |
Iron | 1.48 | 0.74 |
Ca | 119 | 90.6 |
P | 59.3 | 46 |
Vitamin D | 154 | 63 |
Osmolality | 325 | 304 |
n = 29 | Value |
---|---|
Gestation age, week + day; median (IQR) | 26 + 3 (24 + 6–28 + 2) |
Birth weight, g; median (IQR) | 833 (635–1050) |
Male sex; n (%) | 20 (68.9%) |
C section; n (%) | 20 (68.9%) |
Enteral feeds start day; median (IQR) | 2 (2–5) |
Day of life when full feeds achieved; median (IQR) | 30 (16–53) |
TPN days; median (IQR) | 29 (17–61) |
CPF start day; median (IQR) | 47 (31–60) |
Number of days CPF received; median (IQR) | 28 (13–39) |
Retinopathy of Prematurity (ROP) needing treatment *; n (%) | 6 (20.6%) |
Chronic Lung Disease (CLD); n (%) | 18 (62.1%) |
Late onset sepsis (blood) $ | 10 (34.5%) |
Metabolic bone disease | 13 (44.8%) |
Discharge/Transfer gestation week; median (IQR) | 39 (36–44) |
Discharge/Transfer weight g; median (IQR) | 2795 (2300–3907) |
Baby | GA * | Birth Weight (g) | Day of Start of CPF | Days on CPF When Intolerance Noted | Abdominal Distension | Emesis | Change in Stool/Stoma Output | Clinical/Culture Positive Sepsis | If Restarted on CPF |
---|---|---|---|---|---|---|---|---|---|
A | 27 + 1 | 1000 | 58 | 2 | No | Yes | No | Clinical | No |
B | 24 + 0 | 840 | 47 | 10 | No | No | Yes | No | No |
C | 28 + 0 | 574 | 40 | 21 | Yes | No | No | Clinical | Yes |
D | 29 + 6 | 1135 | 29 | 28 | Yes | No | No | Culture | No |
Characteristic | Value |
---|---|
Total observation days on CPF median (IQR) | 34 (24–49) |
Days on CPF 24 kcal/oz median (IQR) | 27 (12.5–35.5) |
Growth velocity prior to CPF (g/kg/day) median (IQR) | 12.53 (11.0–15.4) |
Growth velocity on CPF (g/kg/day) median (IQR) | 15.87 (11.7–19.0) |
Weight at start of CPF (grams) median (IQR) | 1500 (1254–1746) |
Weight at end of CPF (grams) median (IQR) | 2128 (2500–2778) |
Weight gain on CPF (g/day) median (IQR) | 31.4 (22.9–36.2) |
Head growth prior to CPF (n = 13) cm/week median (IQR) | 0.75 (0.53–0.76) |
Head growth on CPF (n = 13) cm/week median (IQR) | 0.79 (0.69–0.86) |
Length growth prior to CPF (n = 12) cm/week median (IQR) | 0.88 (0.84–0.93) |
Length growth on CPF (n = 12) cm/week median (IQR) | 0.77 (0.67–1.08) |
Maximum BUN (n = 27) mmol/L median (IQR) | 2.4 (1.25–4) |
Maximum pre-albumin (n = 27) mg/L median (IQR) | 103 (73.5–119.5) |
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Pillai, A.; Albersheim, S.; Matheson, J.; Lalari, V.; Wei, S.; Innis, S.M.; Elango, R. Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of Feed Intolerance. Nutrients 2018, 10, 1433. https://doi.org/10.3390/nu10101433
Pillai A, Albersheim S, Matheson J, Lalari V, Wei S, Innis SM, Elango R. Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of Feed Intolerance. Nutrients. 2018; 10(10):1433. https://doi.org/10.3390/nu10101433
Chicago/Turabian StylePillai, Anish, Susan Albersheim, Julie Matheson, Vikki Lalari, Sylvia Wei, Sheila M Innis, and Rajavel Elango. 2018. "Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of Feed Intolerance" Nutrients 10, no. 10: 1433. https://doi.org/10.3390/nu10101433