A randomized controlled trial protocol comparing the feeds of fresh versus frozen mother’s own milk for preterm infants in the NICU

Sun, Huiqing; Cao, Yun; Han, Song; Cheng, Rui; Liu, Ling; Liu, Jiang-Qin; Xia, Shiwen; Zhang, Jiajie; Li, Zhankui; Cheng, Xiuyong; Yang, Chuanzhong; Pan, Xinnian; Li, Long; Ding, Xin; Wang, Rensheng; Wu, Min; Li, Xiaoying; Shi, Liping; Xu, Fanxing; Yu, Fengqin; Pan, Jiahua; Zhang, Xiaolan; Li, Li; Yang, Jie; Li, Mingxia; Yan, Changhong; Zhou, Qi; Lü, Jiao; Wei, Mou; Wang, Laishuan; Liu, Yang; Ye, Xiang Y.; Unger, Sharon; Kakulas, Foteini; Lee, Shoo K.

doi:10.1186/s13063-019-3981-4

Cited by 9 publications

(13 citation statements)

References 51 publications

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“…Freezing human milk decreases the energy content and amount and bioactivity of secretory immunoglobulin A, lactoperoxidase, lysozyme, antibacterial factors, and antioxidants. Therefore, a large randomized controlled trial is under way to investigate whether feeding preterm infants with fresh versus frozen mother's own milk results in a lower morbidity and mortality [42].…”

Section: Discussionmentioning

confidence: 99%

Impact of Storage Conditions on the Breast Milk Peptidome

et al. 2020

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Human donor milk (HDM) provides appropriate nutrition and offers protective functions in preterm infants. The aim of the study is to examine the impact of different storage conditions on the stability of the human breast milk peptidome. HDM was directly frozen at −80 °C or stored at −20 °C (120 h), 4 °C (6 h), or room temperature (RT for 6 or 24 h). The milk peptidome was profiled by mass spectrometry after peptide collection by ultrafiltration. Profiling of the peptidome covered 3587 peptides corresponding to 212 proteins. The variance of the peptidome increased with storage temperature and time and varied for different peptides. The highest impact was observed when samples were stored at RT. Smaller but significant effects were still observed in samples stored at 4 °C, while samples showed highest similarity to those immediately frozen at −80 °C when stored at −20 °C. Peptide structures after storage at RT for 24 h point to the increased activity of thrombin and other proteases cleaving proteins at lysine/arginine. The results point to an ongoing protein degradation/peptide production by milk-derived proteases. They underline the need for immediate freezing of HDM at −20 °C or −80 °C to prevent degradation of peptides and enable reproducible investigation of prospectively collected samples.

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Section: Discussionmentioning

confidence: 99%

Impact of Storage Conditions on the Breast Milk Peptidome

et al. 2020

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“…A trial is underway to test whether feeding partial fresh milk each day improves clinical outcomes in premature infants in the NICU. 72…”

Section: Bioactive Componentsmentioning

confidence: 99%

Racial and socioeconomic disparities in breast milk feedings in US neonatal intensive care units

2020

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“…The volumes of donor milk were low and were combined with human milk. The methods of storage and disinfection of donor milk may also have affected its nutritional composition [ 35 , 36 ]. A subgroup analysis was performed to verify dose-related effects of donor milk and own mother’s milk.…”

Section: Discussionmentioning

confidence: 99%

Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants

et al. 2020

BMC Pediatr

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Background and aim Human milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, studies on the association between the dose of human milk and BPD in China are limited. This study aimed to evaluate the dose-dependent effects of human milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants. Methods This retrospective cohort study of preterm infants was conducted on preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. The multivariate analysis was performed to compare the effect outcomes of daily graded doses [1–24 mL/(kg · day), 25–49 mL/(kg · day), and ≥ 50 mL/(kg · day) of body weight] of human milk on neonatal outcomes throughout the first 4 weeks of life versus a reference group receiving no human milk. The models were adjusted for potential confounding variables. Results Of 964 included infants, 279 (28.9%) received exclusive preterm formula, 128 (13.3%) received 1–24 ml/(kg · day), 139 (14.4%) received 25–49 ml/(kg · day), and 418 (43.4%) received ≥50 ml/(kg · day) human milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of human milk daily [≥50 mL/(kg · day)] had lower incidences of BPD [27.5% in ≥50 mL/(kg · day) vs 40.1% in 0 mL/(kg · day) human milk, P = 0.001)], moderate and severe BPD [8.9% in ≥50 mL/(kg · day) vs 16.1% in 0 mL/(kg · day), P = 0.004], necrotizing enterocolitis [NEC; 3.8% in ≥50 mL/(kg · day) vs 10.8% in 0 mL/(kg · day), P = 0.001], late-onset sepsis [LOS; 9.3% in ≥50 mL/(kg · day) vs 19.7% in 0 mL/(kg · day), P <0.01], and extrauterine growth retardation [EUGR; 38.5% in ≥50 mL/(kg · day) vs 57.6% in 0 mL/(kg · day), P <0.01)]. The logistic regression indicated that those receiving ≥50 ml/kg · day human milk had lower odds of BPD [adjusted odds ratio (AOR) 0.453; 95% confidence interval (CI): 0.309, 0.666], moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979). Conclusions A daily threshold amount of ≥50 ml/(kg · day) human milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants. Trial registration ClinicalTrials.gov Identifier: NCT03453502. Registration date: March 5, 2018. This study was retrospectively registered.

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A randomized controlled trial protocol comparing the feeds of fresh versus frozen mother’s own milk for preterm infants in the NICU

Cited by 9 publications

References 51 publications

Impact of Storage Conditions on the Breast Milk Peptidome

Impact of Storage Conditions on the Breast Milk Peptidome

Racial and socioeconomic disparities in breast milk feedings in US neonatal intensive care units

Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants

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