title: Growth and pulmonary outcomes during the first 2 y of life of breastfed and formula-fed infants diagnosed with cystic fibrosis through the Wisconsin Routine Newborn Screening Program.
abstract: BACKGROUND
  The optimal feeding (breast milk, formula, or a combination) for infants with cystic fibrosis (CF) is unknown. Recommendations from the CF Foundation are based on limited data.
  
  
  OBJECTIVE
  We compared growth and pulmonary outcomes between breastfed and formula-fed infants through the age of 2 y.
  
  
  METHODS
  A total of 103 CF infants born in 1994-2006 and diagnosed through newborn screening in Wisconsin were studied. Breastfed infants were classified by the duration of exclusive breastfeeding (ExBF). Exclusive formula-feeding (ExFM) was classified by the formula's caloric density (ie, standard [0.67 kcal/mL (20 kcal/oz) (ExFM20)] throughout infancy or high density [≥0.74 kcal/mL (22 kcal/oz) (ExFM22+)] for some duration of infancy).
  
  
  RESULTS
  Fifty-three infants (51% of infants) were breastfed and 50 infants (49% of infants) were ExFM. In breastfed infants, the duration of ExBF was <1 mo (53% of infants), 1-1.9 mo (21% of infants), 2-3 mo (17% of infants), and 4-9 mo (9% of infants). In ExFM infants, 23 infants (46%) received a formula with a high caloric density; approximately half (n = 13) of the ExFM infants received the formula by 6 mo of age. Proportionately more infants with pancreatic sufficiency (n = 9) were ExBF ≥1 mo (44% of infants), and none of the infants were ExFM22+, compared with infants with meconium ileus (n = 24; 13% of infants were ExBF ≥1 mo, and 38% of infants were ExFM22+) or pancreatic insufficiency (n = 70; 25% of infants were ExBF ≥1 mo, and 20% of infants were ExFM22+) (P = 0.02). In infants with pancreatic insufficiency, weight z scores declined from birth to 6 mo (P < 0.0001) in infants who were ExBF ≥2 mo, and the number of Pseudomonas aeruginosa infections through the age of 2 y was fewer in breastfed than in ExFM infants (P = 0.003) but did not differ by the duration of ExBF.
  
  
  CONCLUSIONS
  For infants with CF, ExBF <2 mo does not compromise growth and is associated with a respiratory benefit.
authors.affiliation: Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Wisconsin, Madison, WI 53706, USA.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Jadin
authors.forename: Grace S
authors.initials: GS
authors.lastname: Wu
authors.forename: Zhumin
authors.initials: Z
authors.lastname: Zhang
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Shoff
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Tippets
authors.forename: Philip M
authors.initials: PM
authors.lastname: Farrell
authors.forename: Tami
authors.initials: T
authors.lastname: Miller
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rock
authors.forename: Hara
authors.initials: H
authors.lastname: Levy
authors.forename: HuiChuan J
authors.initials: HJ
authors.lastname: Lai
mesh_terms: D001942:Breast Feeding; D002657:Child Development; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000178:diet therapy* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology*; D010188:Exocrine Pancreatic Insufficiency / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008168:Lung / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008403:Mass Screening; D008499:Medical Records; D011014:Pneumonia / Q000382:microbiology*; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012720:Severity of Illness Index; D013997:Time Factors; D014922:Wisconsin / Q000453:epidemiology