title: Comparison of lipid and calorie loss from donor human milk among 3 methods of simulated gavage feeding: one-hour, 2-hour, and intermittent gravity feedings.
abstract: OBJECTIVE
  The objective of this study was to compare the differences in lipid loss from 24 samples of banked donor human milk (DHM) among 3 feeding methods: DHM given by syringe pump over 1 hour, 2 hours, and by bolus/gravity gavage.
  
  
  METHODS
  Comparative, descriptive. There were no human subjects.
  
  
  METHODS
  Twenty-four samples of 8 oz of DHM were divided into four 60-mL aliquots. Timed feedings were given by Medfusion 2001 syringe pumps with syringes connected to narrow-lumened extension sets designed for enteral feedings and connected to standard silastic enteral feeding tubes. Gravity feedings were given using the identical syringes connected to the same silastic feeding tubes. All aliquots were analyzed with the York Dairy Analyzer. Univariate repeated-measures analyses of variance were used for the omnibus testing for overall differences between the feeding methods. Lipid content expressed as grams per deciliter at the end of each feeding method was compared with the prefed control samples using the Dunnett's test. The Tukey correction was used for other pairwise multiple comparisons.
  
  
  RESULTS
  The univariate repeated-measures analysis of variance conducted to test for overall differences between feeding methods showed a significant difference between the methods (F = 58.57, df = 3, 69, P < .0001). Post hoc analysis using the Dunnett's approach revealed that there was a significant difference in fat content between the control sample and the 1-hour and 2-hours feeding methods (P < .0001), but we did not find any significant difference in fat content between the control and the gravity feeding methods (P = .3296). Pairwise comparison using the Tukey correction revealed a significant difference between both gravity and 1-hour feeding methods (P < .0001), and gravity and 2-hour feeding method (P < .0001). There was no significant difference in lipid content between the 1-hour and 2-hour feeding methods (P = .2729).
  
  
  CONCLUSIONS
  Unlike gravity feedings, the timed feedings resulted in a statistically significant loss of fat as compared with their controls. These findings should raise questions about how those infants in the neonatal intensive care unit are routinely gavage fed.
authors.affiliation: Texas Health Presbyterian Dallas Neonatal Intensive Care Unit, Dallas, TX 75231, USA. christinebbrooks@texashealth.org
authors.forename: Christine
authors.initials: C
authors.lastname: Brooks
authors.forename: Amy Manning
authors.initials: AM
authors.lastname: Vickers
authors.forename: Subhash
authors.initials: S
authors.lastname: Aryal
mesh_terms: D000284:Administration, Oral; D004041:Dietary Fats / Q000032:analysis*; D002149:Energy Intake; D004750:Enteral Nutrition / Q000379:methods; D005248:Feeding Methods; D006112:Gravitation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008895:Milk, Human / Q000737:chemistry*; D013594:Syringes; D013781:Texas; D013997:Time Factors
chemical_list: D004041:Dietary Fats