ABSTRACT
Objective: The main objective was to describe the impact of full oral feeding achievement in very low birth weight infants on weight, length, and head circumference, measured as the change in z-score from 32 weeks to discharge, the time at which full oral feeding occurs. Methods: This was a longitudinal retrospective observational study on infants younger than 30 weeks of gestational age, admitted to the Neonatology Unit of La Paz University Hospital, Madrid (Spain), from January 1, 2019 to December 31, 2019. The infant's anthropometric characteristics (weight, height, and head circumference) were compared at birth, at 32, 34, and 36 weeks of gestational age, at the time of full oral feeding, and at discharge from the unit. Results: A total of 66 infants were included, gestational age at birth range from 24 to 30. Full oral intake occurred at 37.1 ± 2.1 weeks postmenstrual age (PMA). We found an inverse correlation between gestational age at birth and birth weight with PMA at which full oral feeding (FOF) is achieved. PMA at discharge was 38.6 ± 2.5 weeks. Age of full oral intake and discharge occurred later in infants who had patent ductus arteriosus, retinopathy of prematurity, and sepsis or received a blood transfusion. A positive correlation was found between days of oxygen and both parameters. However, we found no relationship between necrotizing enterocolitis or intraventricular hemorrhage with age at full oral feeding or age at discharge. Conclusions: The transition from gastric tube to oral intake did not affect growth. We found a close relationship between preterm infants birth, earlier younger than 30 weeks of gestational age, and low birth weight, with a delay in full oral feeding achievement that correlated with age at discharge.
ABSTRACT
BACKGROUND: Data are limited on the association between the use of donor human milk and improvements in feeding tolerance. OBJECTIVE: To determine the influence of the duration of parenteral nutrition on the growth and morbidity of the breastfed newborn when using donated human milk in the absence of mother's own milk. METHODS: We conducted a retrospective study before and after the intervention that compared two groups of newborns (N = 284; each group n = 142). We used a convenience sample of all newborns ≤32 weeks gestation consecutively admitted in a single unit before (Group 1 between December 2012 and May 2014) or after (Group 2 between October 2014 and December 2016) the availability of donor human milk. In Group 2, donor human milk was administered at least 3 to 4 weeks or until the baby weighed 1,500 g. Weight was recorded daily and length and head circumference weekly. Parenteral nutrition was continued until enteral feeding volume reached 120 ml/kg/day. Additional variables measured were the number of days with a central venous catheter, age that the enteral feeding volume reached 150 ml/kg/day, and duration of stay. RESULTS: The duration of parenteral feeding was the same before and after: 12 (8.23) and 11 (7.19) days (p = .822). The z scores for weight and height of newborns was lower in Group 2 = -1.8 (1.0) and -2.3 (1.1) and Group 1 = -1.2 (1.1) (p < .001) and -1.8 (1.4) (p = .005). CONCLUSION: We did not find an association between the administration of donor human milk as a supplement to mother's own milk and reduced number of days of parenteral nutrition. Back translation by Laurence Grummer-Strawn.
Subject(s)
Dietary Supplements/supply & distribution , Infant, Premature/growth & development , Milk, Human/metabolism , Parenteral Nutrition/standards , Time Factors , Adult , Dietary Supplements/statistics & numerical data , Female , Humans , Infant , Infant Nutritional Physiological Phenomena , Infant, Newborn , Infant, Premature/metabolism , Male , Milk Banks/statistics & numerical data , Milk Banks/supply & distribution , Parenteral Nutrition/methods , Parenteral Nutrition/statistics & numerical data , Retrospective StudiesABSTRACT
AIM: The aim of the present study is to evaluate the effect of human milk feeding during the first weeks of life in very low birth weight infants on weight gain at discharge, length of hospitalization, postmenstrual age at discharge and nutritional assessment, growth and neurodevelopment at two and five years. MATERIAL AND METHODS: Longitudinal study of very-low-birth-weight infants (< 1,500 grams) admitted to the Neonatal Intensive Care Unit of La Paz University Hospital, from January 1st 2009 to December 31st 2009, followed in the follow-up clinic. Their parents agreed to perform a more exhaustive anthropometric study at five years, classified according to the type of feeding at the time of discharge (exclusive human milk, formula milk or mixed). Initial hospital duration and anthropometry at discharge were evaluated. At two years of age, anthropometric data (weight, height and head circumference) were collected and neurodevelopment was assessed according to the Bayley scale of child development. Data at five years were collected prospectively. Measurements of weight, height and head circumference, waist circumference, hip, relaxed and contracted arm, thigh and middle leg, bicipital, triceps, subscapular, suprailiac and leg skin folds were performed. For patients older than five years, the Kaufman test battery for children was used. The effect of human milk on the variables of interest was investigated using a multivariate analysis correcting for gestational age and weight at birth. RESULTS: One hundred and fifty-two infants born in 2009 were discharged from our unit: exclusive breast milk (59), formula (55) or mixed milk (38). More detailed follow-up was carried out for 61 of them. Human milk during the first admission decreases the initial hospital stay, and is associated with a higher head circumference at two and five years, and a better score in the global and verbal cognitive area at five years. CONCLUSIONS: Our results suggest that maternal milk feeding during initial admission should be encouraged because it can improve neurodevelopment at five years of age.
Subject(s)
Infant, Very Low Birth Weight , Milk, Human , Breast Feeding , Child, Preschool , Female , Growth , Humans , Infant , Infant Formula , Infant Nutritional Physiological Phenomena , Infant, Newborn , Longitudinal Studies , Male , Nutrition AssessmentABSTRACT
Objetivo: el objetivo del presente estudio es evaluar el efecto de la alimentación con leche materna durante las primeras semanas de vida en los recién nacidos de muy bajo peso sobre: la ganancia ponderal en el momento del alta, la duración de la estancia hospitalaria, la edad posmenstrual al alta y el estado nutricional, el crecimiento y el neurodesarrollo a los dos y cinco años. Material y métodos: estudio longitudinal de recién nacidos de muy bajo peso al nacer (< 1.500 gramos), ingresados en la Unidad de Cuidados Intensivos Neonatales del Hospital Universitario La Paz del 1 de enero de 2009 al 31 de diciembre de 2009, cuyo seguimiento se está realizando en la consulta de Neonatología y sus padres aceptaron realizar un estudio antropométrico más exhaustivo a los cinco años, teniendo en cuenta la ingesta al alta de leche materna exclusiva, leche de fórmula o mixta. Se evaluaron la estancia hospitalaria y la antropometría al alta. A los dos años de edad se recogieron datos antropométricos (peso, talla y perímetro cefálico) y se realizó valoración del neurodesarrollo según la escala de Bayley II de desarrollo infantil. Los datos a los cinco años fueron recogidos prospectivamente. Se realizaron medidas de peso, talla y perímetro cefálico, perímetros de cintura, cadera, brazo relajado y contraído, muslo y pierna media, pliegues bicipitales, tricipital, subescapular, suprailiaco y pierna. Para los pacientes mayores de cinco años, se utilizó la batería de evaluación de Kaufman para niños. El efecto de la ingesta de leche materna en las variables de interés se investigó usando un análisis multivariante corrigiendo por edad gestacional y peso de recién nacido. Resultados: ciento cincuenta y dos niños fueron dados de alta: leche materna exclusiva (59), leche de fórmula (55) o mixta (38). A 61 de ellos se les realizó un seguimiento más exhaustivo. La ingesta de leche materna durante el primer ingreso disminuye la estancia hospitalaria inicial, y se asocia con mayor perímetro cefálico a los dos y a los cinco años y mejor puntuación en el área cognitiva global y verbal a los cinco años. Conclusiones: nuestros resultados sugieren que la alimentación con leche de la propia madre durante el ingreso inicial debe ser fomentada porque puede mejorar el neurodesarrollo a los cinco años de edad (AU)
Aim: The aim of the present study is to evaluate the effect of human milk feeding during the first weeks of life in very low birth weight infants on weight gain at discharge, length of hospitalization, postmenstrual age at discharge and nutritional assessment, growth and neurodevelopment at two and five years. Material and methods: Longitudinal study of very-low-birth-weight infants (< 1,500 grams) admitted to the Neonatal Intensive Care Unit of La Paz University Hospital, from January 1st 2009 to December 31st 2009, followed in the follow-up clinic. Their parents agreed to perform a more exhaustive anthropometric study at five years, classified according to the type of feeding at the time of discharge (exclusive human milk, formula milk or mixed). Initial hospital duration and anthropometry at discharge were evaluated. At two years of age, anthropometric data (weight, height and head circumference) were collected and neurodevelopment was assessed according to the Bayley scale of child development. Data at five years were collected prospectively. Measurements of weight, height and head circumference, waist circumference, hip, relaxed and contracted arm, thigh and middle leg, bicipital, triceps, subscapular, suprailiac and leg skin folds were performed. For patients older than five years, the Kaufman test battery for children was used. The effect of human milk on the variables of interest was investigated using a multivariate analysis correcting for gestational age and weight at birth. Results: One hundred and fifty-two infants born in 2009 were discharged from our unit: exclusive breast milk (59), formula (55) or mixed milk (38). More detailed follow-up was carried out for 61 of them. Human milk during the first admission decreases the initial hospital stay, and is associated with a higher head circumference at two and five years, and a better score in the global and verbal cognitive area at five years. Conclusions: Our results suggest that maternal milk feeding during initial admission should be encouraged because it can improve neurodevelopment at five years of age (AU)
