title: Breast milk supplementation and preterm infant development after hospital discharge: a randomized clinical trial.
abstract: OBJECTIVE
  To assess the effect of maternal breast milk supplementation on the development of exclusively breast-fed very low birth weight preterm infants at 12 months of corrected age.
  
  
  METHODS
  A randomized clinical trial with 53 infants followed-up after discharge from the neonatal unit until a corrected gestational age of 12 months. Newborns in the intervention group were breastfed exclusively with maternal milk and received 2g of a multinutrient supplement (Pré-Nan(®), Nestlé, Vevey, Switzerland) added to expressed breast milk twice a day until a corrected age of 4-6 months. The control group was exclusively breastfed without supplementation. After monthly follow-up, developmental assessment was performed using the Bayley III Scale.
  
  
  RESULTS
  There was no statistically significant difference on the Bayley III Scale between the intervention and control groups in any of the assessed domains: motor, cognitive, and communication. However, scores in the three domains were always higher in the group that received the supplement. There were a similar number of cases of developmental delay in both groups: seven (28%) in the group that received the supplement and nine (33.3%) in the group that was exclusively breastfed.
  
  
  CONCLUSIONS
  The results failed to show an association between post-discharge multinutrient supplementation and development in the assessed infants.
authors.affiliation: Hospital Universitário Materno-Infantil, São Luís, MA, Brazil; Universidade Federal do Maranhão (UFMA), São Luís, MA, Brazil. Electronic address: roxanacunha@hotmail.com.
authors.forename: Roxana Desterro E Silva
authors.initials: RD
authors.lastname: da Cunha
authors.affiliation: Departamento de Medicina, Universidade Federal do Maranhão (UFMA), São Luís, MA, Brazil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lamy Filho
authors.affiliation: Hospital Universitário Materno-Infantil, São Luís, MA, Brazil; Universidade Federal do Maranhão (UFMA), São Luís, MA, Brazil.
authors.forename: Eremita Val
authors.initials: EV
authors.lastname: Rafael
authors.affiliation: Departamento de Medicina, Universidade Federal do Maranhão (UFMA), São Luís, MA, Brazil.
authors.forename: Zeni Carvalho
authors.initials: ZC
authors.lastname: Lamy
authors.affiliation: Faculdade de Medicina, Universidade Federal do Maranhão (UFMA), São Luís, MA, Brazil; Institutional Program for Scientific Initiation Scholarships (PIBIC), Brazil.
authors.forename: André Luiz Guimarães
authors.initials: AL
authors.lastname: de Queiroz
mesh_terms: D001942:Breast Feeding; D016022:Case-Control Studies; D002657:Child Development / Q000502:physiology*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development / Q000502:physiology*; D019102:Infant, Very Low Birth Weight / Q000254:growth & development / Q000502:physiology*; D008297:Male; D009483:Neuropsychological Tests; D010351:Patient Discharge
keywords: Alta hospitalar; Amamentação; Breastfeeding; Desenvolvimento; Development; Hospital discharge; Human milk; Leite Materno; Prematuro; Preterm