title: Formula Feeding Is Independently Associated With Acute Kidney Injury in Very Low Birth Weight Infants.
abstract: BACKGROUND
  Successful strategies to prevent neonatal acute kidney injury are lacking. Nevertheless, it is well known that in breastfed babies the excretory needs of the kidney are low because the intake of most nutrients is just above the nutritional requirement.
  
  
  OBJECTIVE
  This study aimed to determine whether feeding type predicts acute kidney injury in the very low birth weight infant.
  
  
  METHODS
  One hundred and eighty-six infants were enrolled in this pre-post cohort study (114 infants were included in the only human milk-fed group and 72 in the formula-fed group). Routine biological markers of acute kidney injury were collected in both groups from birth to discharge.
  
  
  RESULTS
  Compared with formula feeding, human milk feeding was associated with almost 80% lower odds of acute kidney injury (odds ratio [OR] = 0.2; 95% confidence interval [CI], 0.05-0.77). After confounding variables had been controlled for, formula feeding was independently associated with acute kidney injury in very low birth weight infants.
  
  
  CONCLUSIONS
  The study showed that, at our institution, acute kidney injury in the neonatal period is frequently associated with the avoidable procedure of formula feeding. Further prospective multicenter studies are needed to determine the generality of this association.
authors.affiliation: 1 Neonatal Unit, Department of Paediatrics, Hospital de la Santa Creu i Sant Pau, Barcelona Free University (UAB), Barcelona, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Ginovart
authors.affiliation: 2 Department of Clinical Epidemiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Ignasi
authors.initials: I
authors.lastname: Gich
authors.affiliation: 3 Department of Primary Care, Balearic Health Authority, Health Sciences Research Institute (IUNICS), Balearic University, Palma de Mallorca, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Verd
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000009:adverse effects* / Q000592:standards; D007227:Infant Nutritional Physiological Phenomena / Q000187:drug effects; D019102:Infant, Very Low Birth Weight / Q000378:metabolism*; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration; D008895:Milk, Human / Q000378:metabolism; D012307:Risk Factors
keywords: acute kidney injury; breastfeeding; milk bank; newborn infant