Inoculation of mother's own milk could personalize pasteurized donor human milk used for feeding preterm infants.

BACKGROUND: Human milk is a vehicle for bioactive compounds and beneficial bacteria which promote the establishment of a healthy gut microbiome of newborns, especially of preterm infants. Pasteurized donor human milk (PDHM) is the second-best option when preterm mother's own milk is unavailable. Since pasteurization affect the microbiological quality of donor milk, PDHM was inoculated with different preterm milk samples and then incubated, in order to evaluate the effect in terms of bacterial growth, human milk microbiome and proteolytic phenomena. METHODS: In an in-vitro study PDHM was inoculated at 10% v/v using ten preterm milk samples. Microbiological, metataxonomic and peptidomic analyses, on preterm milk samples at the baseline (T0), on PDHM and on inoculated milk (IM) samples at T0, after 2 h (T1) and 4 h (T2) of incubation at 37 °C, were conducted. RESULTS: IM samples at T2 showed a Total Bacterial Count not significantly different (p > 0.01) compared to preterm milk samples. At T2 lactic acid bacteria level was restored in all IM. After inoculation, metataxonomic analysis in IM samples showed that Proteobacteria remained the predominant phylum while Firmicutes moved from 3% at T1 to 9.4% at T2. Peptidomic profile of IM resembled that of PDHM, incubated for the same time, in terms of number and type of peptides. CONCLUSION: The study demonstrated that inoculation of PDHM with mother's own milk could restore bacterial growth and personalize human milk microbiome in PDHM. This effect could be beneficial because of the presence of maternal probiotic bacteria which make PDHM more similar to mother's own milk.

[Growth and body composition changes in late preterm infants in the first months of life]. / Crescita e composizione corporea di neonati late-preterm nei primi mesi di vita.

OBJECTIVES: The aim of this study was to compare growth and body composition of late preterm infants to that of extremely preterm and full-term infants. METHODS: Observational longitudinal study. Forty-nine late preterm infants and 63 extremely preterm infants were included in the study. Forty healthy, full-term, breast-fed infants were enrolled as a reference group. Anthropometric parameters and body composition by an air displacement plethysmography system were assessed at 36th week, at term, at 1 and 3 months of corrected age in all groups. Late preterm infants were also assessed on the fifth day of life. RESULTS: Late preterm infants showed higher weight, length and head circumference values than those of very low birth weight infants but lower fat mass values on the fifth day of life and at 36th week of corrected age. However, at 3 months of corrected age, percentage of fat mass in late preterm infants reached values comparable with those of very low birth weight infants, probably because of the fast catch-up fat recorded between the fifth day of life and term corrected age. Moreover, percentage of fat mass in the first month of corrected age in preterm infants was higher as compared with full-term infants. This difference was no longer found at 3 months of corrected age. CONCLUSIONS: Further studies are needed to investigate whether this rapid increase in fat mass may modulate the risk of chronic diseases.

[Quality of post-discharge growth in small for gestational age preterm infants: an explorative study]. / Qualità della crescita post-dimissione in prematuri nati piccoli per età gestazionale: studio esplorativo.

OBJECTIVES: The Preterm newborns, especially if born small for gestational age (SGA), appear to be at risk for developing post-natal growth failure and an altered body composition. Nutrition-related growth during a critical window in infancy may affect the development of metabolic syndrome in adult life. Aim of the present study was to test the hypothesis that the post-discharge period is critical for programming the catch up growth and the later development of metabolic syndrome in small for gestational-age infants fed either standard or enriched formula. METHODS: A clinic randomized explorative study was conducted. Twenty-seven preterm SGA infants (gestational age < or = 33 weeks; birth weight < or = 1500 g) underwent assessment of growth and body composition by means of an air displacement system at 36 weeks, 15 days and 1 months adjusted age. SGA infants were randomized to receive standard formula (Kcal: 67/100 ml, proteins: 1,4 g/100 ml) or enriched formula (Kcal: 75/100 ml, proteins: 2 g/100 ml) after discharge. RESULTS: No differences in weight, fat mass, length and head circumference were found in SGA infants fed standard formula as compared to those fed enriched formula at 15 day or 1 months adjusted age. CONCLUSIONS: This explorative study suggests that in SGA infants growth, both in terms of quantity and quality, is not influenced by different nutritional management during the early post-discharge period.

Influence of protein and energy intakes on body composition of formula-fed preterm infants after term.

The aim of the present study was to evaluate changes in body composition in 48 preterm infants in relation to protein and energy intakes from term up to 3 months of corrected age, using air displacement plethysmography. Protein intake (grams per kilogram per day) was negatively associated with percentage of fat mass at 1 month of corrected age. The high-protein-intake group showed greater gain in lean body mass gain than did the low-protein-intake group. This finding suggests that during the first month of corrected age, high protein intake results in a significantly different weight gain composition.

[Quality of growth in preterm infants assessed at term equivalent age: a pilot study]. / E possibile mimare nel neonato pretermine la composizione corporea fetale? Uno studio pilota.

BACKGROUND: The American Academy of Pediatrics (AAP) recommends that preterm infants' growth duplicates fetal growth rates and that body composition replicates in utero body composition. Aim ofthe study was to compare the total body fat mass between preterm infants assessed at term and full-term newborns. METHODS: A prospective observational study was conducted. Forty-five preterm infants (mean (SD) gestational age: 30,1 (2.3) weeks; birth weight: 1125 (280) g), and 40 full term (mean (SD) 38.5 (1.2) weeks, 3203 (385) g, breast fed infants underwent assessment of growth and body composition by means of an air displacement system at term adjusted-age and on day 3 of life, respectively. A T test was used to compare % fat mass between preterm and term infants. RESULTS: Weight, length and head circumference were smaller in the preterm group assessed at term adjusted-age as compared to the term group. Mean (SD) percentage of fat mass in preterm infants was significantly higher as compared to term infants [14.5 (4.3) vs 7,6 (3.6), P < 0.0001]. CONCLUSIONS: Our data demonstrate that preterm infants are at risk of developing an increased adiposity in addition to postnatal growth retardation.