Association between type of feeding at discharge from the hospital and nutritional status of very low birth weight preterm infants

Abstract

The ideal feeding for premature babies has been the source of extensive debate. The aim of this study was to assess the association between type of feeding at discharge and the nutritional status of very low birth weight infants. This was a retrospective cohort of preterm babies with birth weight ≤1500 g, born between January 2006 and December 2013. The infants were divided into 3 groups according to type of feeding at discharge: exclusive breast milk (group 1), mixed feeding (group 2) and exclusive artificial formula (group 3). Frequencies of each group were calculated, as well as mean Z-score differences in weight, length and head circumference. Six hundred and forty-nine newborns were included. The mean weight of groups 1, 2, and 3 was 1338.7, 1104.0, and 1254.7 g, respectively, and their mean gestational age was 31.9, 30, and 31.2 weeks, respectively. The Z-score differences (means±SD) for groups 1, 2, and 3 were: −0.84±0.68, −1.02±0.75, and −0.86±0.71 for weight, −0.21±1.23, −0.52±1.64 and −0.08±1.34 for head circumference, and −1.10±1.18, −1.54±1.37, and −0.97±1.21 for length. A significant difference was observed between groups 2 and 3 in the adjusted Z-score model for length, with no significant differences in anthropometric measurements for the other comparative analyses. Because of its many advantages, breastfeeding should be stimulated within neonatal units since nutritional status was not influenced by the different types of feeding.

Effects of Formula Milk Feeding in Premature Infants: A Systematic Review

“…In terms of growth, the best results were observed with FM [20,27,31], with the combination of BM and FM [32] and with two liquid fortifiers [26,30]. In the remaining studies, the results were similar [19,24,28,35], and, in one study, DHM was associated with reduced growth [29]. Morbidity did not differ statistically according to the type of feeding [19,22,24,26,34,35], although in several studies there was a higher incidence with FM [30][31][32].…”

“…A total of 18 articles were selected, of which eight were experimental studies [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ] and the remaining ten were observational studies [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ] ( Figure 1 ). The characteristics of the applied interventions are presented in Table 2 .…”

“…There was also a significant association between lower HC and increased DHM, but not with FM [ 29 ]. However, Martins-Celini et al [ 28 ] and Lofti et al [ 32 ] did not identify any significant difference in weight or HC between the different feeding modalities at hospital discharge, although the length was significantly shorter in infants fed with BM or DHM compared to the FM group. In Brownell et al [ 29 ], both BM and DHM were fortified (caloric density of 67 kcal per 100 mL) when 100 mL/kg/day was reached and progressed to a total volume of 140–160 mL/kg/day.…”

“…The methodological characteristics of the analyzed studies are detailed in Table 3. Among the objectives of the analyzed investigations, we distinguished nine that compared the effects of feeding with FM, BM, and DHM [21,25,[27][28][29]32,33,35,36], five that evaluated the effects of different compositions of FM and/or fortifiers [19,24,26,30,34], and four investigations that compared the effects of FM and DHM [20,22,23,31]. The methodological characteristics of the analyzed studies are detailed in Table 3.…”

Factors Associated With Breastfeeding Very Low Birth Weight Infants at Neonatal Intensive Care Unit Discharge: A Single-Center Brazilian Experience

“…In a recently published study (Martins-Celini et al, 2018), the investigators explored the association between the type of feeding at discharge and the nutritional status of VLBW infants in a Brazilian NICU. They divided their participants according to the type of diet at discharge in the same way that we did.…”