Growth in VLBW infants fed predominantly fortified maternal and donor human milk diets: a retrospective cohort study.
BACKGROUND
To determine the effect of human milk, maternal and donor, on in-hospital growth of very low birthweight (VLBW) infants. We performed a retrospective cohort study comparing in-hospital growth in VLBW infants by proportion of human milk diet, including subgroup analysis by maternal or donor milk type. Primary outcome was change in weight z-score from birth to hospital discharge.


METHODS
Retrospective cohort study.


RESULTS
171 infants with median gestational age 27 weeks (IQR 25.4, 28.9) and median birthweight 899 g (IQR 724, 1064) were included. 97% of infants received human milk, 51% received > 75% of all enteral intake as human milk. 16% of infants were small-for-gestational age (SGA, < 10th percentile) at birth, and 34% of infants were SGA at discharge. Infants fed >75% human milk had a greater negative change in weight z-score from birth to discharge compared to infants receiving < 75% (-0.6 vs, -0.4, p = 0.03). Protein and caloric supplementation beyond standard human milk fortifier was related to human milk intake (p = 0.04). Among infants receiving > 75% human milk, there was no significant difference in change in weight z-score by milk type (donor -0.84, maternal -0.56, mixed -0.45, p = 0.54). Infants receiving >75% donor milk had higher rates of SGA status at discharge than those fed maternal or mixed milk (56% vs. 35% (maternal), 21% (mixed), p = 0.08).


CONCLUSIONS
VLBW infants can grow appropriately when fed predominantly fortified human milk. However, VLBW infants fed >75% human milk are at greater risk of poor growth than those fed less human milk. This risk may be highest in those fed predominantly donor human milk.
Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, USA. tarah-colaizy@uiowa.edu
Tarah T
TT
Colaizy
Susan
S
Carlson
Audrey F
AF
Saftlas
Frank H
FH
Morriss
D015331:Cohort Studies; D004044:Dietary Proteins; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005527:Food, Fortified; D006801:Humans; D041943:Infant Formula; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007236:Infant, Small for Gestational Age; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D008297:Male; D008895:Milk, Human; D012189:Retrospective Studies; D015430:Weight Gain
D004044:Dietary Proteins