Improving Growth for Infants ≤1250 Grams Receiving an Exclusive Human Milk Diet
Background An exclusive human milk diet (EHM) fortified with human milk‐based fortifier decreases necrotizing enterocolitis (NEC) compared to maternal milk supplemented with preterm formula and bovine fortifier (PTF). Growth has been less with EHM and also maternal milk supplemented with donor human...
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| Veröffentlicht in: | Nutrition in clinical practice 2018-10, Vol.33 (5), p.671-678 |
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| container_title | Nutrition in clinical practice |
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| creator | Huston, Robert K. Markell, Andrea M. McCulley, Elizabeth A. Gardiner, Stuart K. Sweeney, Sean L. |
| description | Background
An exclusive human milk diet (EHM) fortified with human milk‐based fortifier decreases necrotizing enterocolitis (NEC) compared to maternal milk supplemented with preterm formula and bovine fortifier (PTF). Growth has been less with EHM and also maternal milk supplemented with donor human milk and bovine fortifier (HMBF). The objective was to evaluate the effect of a standardized feeding protocol on the growth of infants ≤1250 g birth weight supported with EHM and HMBF. The effect on the incidence of NEC was also evaluated.
Design/Methods
A retrospective study of growth before and after implementation of a feeding protocol for infants who received either EHM or HMBF. Primary outcomes were weight, length, and head circumference gain velocities from birth to discharge. The incidence of NEC was also recorded.
Results
Analysis of covariance for 379 total infants showed that earlier day of life for fortification to 24 Kcal/oz was associated with increased weight gain (p = 0.0166) and length gain (p = 0.0064). Implementation of the feeding protocol was associated with increased head circumference gain (p = 0.006). EHM was associated with decreased incidence of NEC (p = 0.0302).
Conclusions
Implementation of a standardized feeding protocol including earlier fortification of maternal milk was associated with improved growth for infants receiving human milk feedings. EHM significantly decreased NEC. Earlier fortification had no effect on NEC. |
| doi_str_mv | 10.1002/ncp.10054 |
| format | Article |
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An exclusive human milk diet (EHM) fortified with human milk‐based fortifier decreases necrotizing enterocolitis (NEC) compared to maternal milk supplemented with preterm formula and bovine fortifier (PTF). Growth has been less with EHM and also maternal milk supplemented with donor human milk and bovine fortifier (HMBF). The objective was to evaluate the effect of a standardized feeding protocol on the growth of infants ≤1250 g birth weight supported with EHM and HMBF. The effect on the incidence of NEC was also evaluated.
Design/Methods
A retrospective study of growth before and after implementation of a feeding protocol for infants who received either EHM or HMBF. Primary outcomes were weight, length, and head circumference gain velocities from birth to discharge. The incidence of NEC was also recorded.
Results
Analysis of covariance for 379 total infants showed that earlier day of life for fortification to 24 Kcal/oz was associated with increased weight gain (p = 0.0166) and length gain (p = 0.0064). Implementation of the feeding protocol was associated with increased head circumference gain (p = 0.006). EHM was associated with decreased incidence of NEC (p = 0.0302).
Conclusions
Implementation of a standardized feeding protocol including earlier fortification of maternal milk was associated with improved growth for infants receiving human milk feedings. EHM significantly decreased NEC. Earlier fortification had no effect on NEC.</description><identifier>ISSN: 0884-5336</identifier><identifier>EISSN: 1941-2452</identifier><identifier>DOI: 10.1002/ncp.10054</identifier><identifier>PMID: 29451716</identifier><language>eng</language><publisher>United States</publisher><subject>Animals ; Birth Weight ; Body Height ; breast milk ; breast milk fortification ; Cattle ; Clinical Protocols ; Diet ; donor human milk ; Enteral Nutrition - methods ; Enterocolitis, Necrotizing - prevention & control ; Female ; Food, Formulated ; Food, Fortified ; Head ; human milk ; Humans ; Infant ; Infant Formula - chemistry ; infant necrotizing enterocolitis ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Male ; milk banks ; Milk, Human ; Nursing ; Nutritional Status ; Retrospective Studies ; Weight Gain</subject><ispartof>Nutrition in clinical practice, 2018-10, Vol.33 (5), p.671-678</ispartof><rights>2018 American Society for Parenteral and Enteral Nutrition</rights><rights>2018 American Society for Parenteral and Enteral Nutrition.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3254-484ac47b039305a301c4baf74b38b40f76664a559c6cefa89cfca9bf21e9302a3</citedby><cites>FETCH-LOGICAL-c3254-484ac47b039305a301c4baf74b38b40f76664a559c6cefa89cfca9bf21e9302a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fncp.10054$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fncp.10054$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29451716$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huston, Robert K.</creatorcontrib><creatorcontrib>Markell, Andrea M.</creatorcontrib><creatorcontrib>McCulley, Elizabeth A.</creatorcontrib><creatorcontrib>Gardiner, Stuart K.</creatorcontrib><creatorcontrib>Sweeney, Sean L.</creatorcontrib><title>Improving Growth for Infants ≤1250 Grams Receiving an Exclusive Human Milk Diet</title><title>Nutrition in clinical practice</title><addtitle>Nutr Clin Pract</addtitle><description>Background
An exclusive human milk diet (EHM) fortified with human milk‐based fortifier decreases necrotizing enterocolitis (NEC) compared to maternal milk supplemented with preterm formula and bovine fortifier (PTF). Growth has been less with EHM and also maternal milk supplemented with donor human milk and bovine fortifier (HMBF). The objective was to evaluate the effect of a standardized feeding protocol on the growth of infants ≤1250 g birth weight supported with EHM and HMBF. The effect on the incidence of NEC was also evaluated.
Design/Methods
A retrospective study of growth before and after implementation of a feeding protocol for infants who received either EHM or HMBF. Primary outcomes were weight, length, and head circumference gain velocities from birth to discharge. The incidence of NEC was also recorded.
Results
Analysis of covariance for 379 total infants showed that earlier day of life for fortification to 24 Kcal/oz was associated with increased weight gain (p = 0.0166) and length gain (p = 0.0064). Implementation of the feeding protocol was associated with increased head circumference gain (p = 0.006). EHM was associated with decreased incidence of NEC (p = 0.0302).
Conclusions
Implementation of a standardized feeding protocol including earlier fortification of maternal milk was associated with improved growth for infants receiving human milk feedings. EHM significantly decreased NEC. Earlier fortification had no effect on NEC.</description><subject>Animals</subject><subject>Birth Weight</subject><subject>Body Height</subject><subject>breast milk</subject><subject>breast milk fortification</subject><subject>Cattle</subject><subject>Clinical Protocols</subject><subject>Diet</subject><subject>donor human milk</subject><subject>Enteral Nutrition - methods</subject><subject>Enterocolitis, Necrotizing - prevention & control</subject><subject>Female</subject><subject>Food, Formulated</subject><subject>Food, Fortified</subject><subject>Head</subject><subject>human milk</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant Formula - chemistry</subject><subject>infant necrotizing enterocolitis</subject><subject>Infant Nutritional Physiological Phenomena</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Very Low Birth Weight</subject><subject>Male</subject><subject>milk banks</subject><subject>Milk, Human</subject><subject>Nursing</subject><subject>Nutritional Status</subject><subject>Retrospective Studies</subject><subject>Weight Gain</subject><issn>0884-5336</issn><issn>1941-2452</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEtOwzAQhi0EoqWw4ALIS1iE-pnHEpXSVipPwdpyjA2GPNo4aekRuAcn4yS4TWHHymPNN_-MPgCOMTrHCJF-oWbrgrMd0MUJwwFhnOyCLopjFnBKww44cO4NIRzTKN4HHZIwjiMcdsH9JJ9V5cIWL3BUlcv6FZqygpPCyKJ28PvzCxOOfEvmDj5ope0GlQUcfqiscXah4bjJ_f_aZu_w0ur6EOwZmTl9tH174Olq-DgYB9Pb0WRwMQ0UJZwFLGZSsShFNKGIS4qwYqk0EUtpnDJkojAMmeQ8UaHSRsaJMkomqSFY-wEiaQ-ctrn-_nmjXS1y65TOMlnosnGCIEQR86uYR89aVFWlc5U2YlbZXFYrgZFYGxTeoNgY9OzJNrZJc_38R_4q80C_BZY206v_k8TN4K6N_AE2QHmW</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Huston, Robert K.</creator><creator>Markell, Andrea M.</creator><creator>McCulley, Elizabeth A.</creator><creator>Gardiner, Stuart K.</creator><creator>Sweeney, Sean L.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201810</creationdate><title>Improving Growth for Infants ≤1250 Grams Receiving an Exclusive Human Milk Diet</title><author>Huston, Robert K. ; Markell, Andrea M. ; McCulley, Elizabeth A. ; Gardiner, Stuart K. ; Sweeney, Sean L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3254-484ac47b039305a301c4baf74b38b40f76664a559c6cefa89cfca9bf21e9302a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Animals</topic><topic>Birth Weight</topic><topic>Body Height</topic><topic>breast milk</topic><topic>breast milk fortification</topic><topic>Cattle</topic><topic>Clinical Protocols</topic><topic>Diet</topic><topic>donor human milk</topic><topic>Enteral Nutrition - methods</topic><topic>Enterocolitis, Necrotizing - prevention & control</topic><topic>Female</topic><topic>Food, Formulated</topic><topic>Food, Fortified</topic><topic>Head</topic><topic>human milk</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant Formula - chemistry</topic><topic>infant necrotizing enterocolitis</topic><topic>Infant Nutritional Physiological Phenomena</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Very Low Birth Weight</topic><topic>Male</topic><topic>milk banks</topic><topic>Milk, Human</topic><topic>Nursing</topic><topic>Nutritional Status</topic><topic>Retrospective Studies</topic><topic>Weight Gain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huston, Robert K.</creatorcontrib><creatorcontrib>Markell, Andrea M.</creatorcontrib><creatorcontrib>McCulley, Elizabeth A.</creatorcontrib><creatorcontrib>Gardiner, Stuart K.</creatorcontrib><creatorcontrib>Sweeney, Sean L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nutrition in clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huston, Robert K.</au><au>Markell, Andrea M.</au><au>McCulley, Elizabeth A.</au><au>Gardiner, Stuart K.</au><au>Sweeney, Sean L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improving Growth for Infants ≤1250 Grams Receiving an Exclusive Human Milk Diet</atitle><jtitle>Nutrition in clinical practice</jtitle><addtitle>Nutr Clin Pract</addtitle><date>2018-10</date><risdate>2018</risdate><volume>33</volume><issue>5</issue><spage>671</spage><epage>678</epage><pages>671-678</pages><issn>0884-5336</issn><eissn>1941-2452</eissn><abstract>Background
An exclusive human milk diet (EHM) fortified with human milk‐based fortifier decreases necrotizing enterocolitis (NEC) compared to maternal milk supplemented with preterm formula and bovine fortifier (PTF). Growth has been less with EHM and also maternal milk supplemented with donor human milk and bovine fortifier (HMBF). The objective was to evaluate the effect of a standardized feeding protocol on the growth of infants ≤1250 g birth weight supported with EHM and HMBF. The effect on the incidence of NEC was also evaluated.
Design/Methods
A retrospective study of growth before and after implementation of a feeding protocol for infants who received either EHM or HMBF. Primary outcomes were weight, length, and head circumference gain velocities from birth to discharge. The incidence of NEC was also recorded.
Results
Analysis of covariance for 379 total infants showed that earlier day of life for fortification to 24 Kcal/oz was associated with increased weight gain (p = 0.0166) and length gain (p = 0.0064). Implementation of the feeding protocol was associated with increased head circumference gain (p = 0.006). EHM was associated with decreased incidence of NEC (p = 0.0302).
Conclusions
Implementation of a standardized feeding protocol including earlier fortification of maternal milk was associated with improved growth for infants receiving human milk feedings. EHM significantly decreased NEC. Earlier fortification had no effect on NEC.</abstract><cop>United States</cop><pmid>29451716</pmid><doi>10.1002/ncp.10054</doi><tpages>8</tpages></addata></record> |
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| ispartof | Nutrition in clinical practice, 2018-10, Vol.33 (5), p.671-678 |
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| source | Wiley-Blackwell Journals; MEDLINE |
| subjects | Animals Birth Weight Body Height breast milk breast milk fortification Cattle Clinical Protocols Diet donor human milk Enteral Nutrition - methods Enterocolitis, Necrotizing - prevention & control Female Food, Formulated Food, Fortified Head human milk Humans Infant Infant Formula - chemistry infant necrotizing enterocolitis Infant Nutritional Physiological Phenomena Infant, Newborn Infant, Premature Infant, Very Low Birth Weight Male milk banks Milk, Human Nursing Nutritional Status Retrospective Studies Weight Gain |
| title | Improving Growth for Infants ≤1250 Grams Receiving an Exclusive Human Milk Diet |
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