Availability of donor milk improves enteral feeding but has limited effect on body growth of infants with very‐low birthweight: Data from a historic cohort study

Abstract

Compare with preterm formula, donor human milk (DM) is associated with a lower risk of mortality and morbidity in preterm infants. It is thus deemed superior to preterm formula as the sole diet or supplement to own mother's milk (OMM) for preterm infants, especially for those with very low birthweight (VLBW). This historic cohort study investigated the relationship between DM availability, and enteral feeding, body growth of VLBW infants by comparing two cohorts before and after the establishment of a human milk bank. A sub-analysis was also conducted between small-for-gestational-age (SGA) and non-SGA infants in our cohorts. Our results showed that DM availability was associated with earlier initiation and faster advancement of enteral feeding, earlier attainment of full enteral feeding, and a higher proportion of OMM in enteral feeding. DM availability was also associated with earlier regain of birthweight, but not with better body growth. SGA and non-SGA infants responded differently to DM availability with only the non-SGA group showing improved enteral feeding associated with DM availability. The poor growth of VLBW infants with fortified DM warrants further investigations on better fortification strategies to further improve body growth. Studies are also needed on long-term effects of DM feeding on the development of VLBW infants.

Time to Reach Full Enteral Feeding and Its Predictors among Very Low Birth Weight Neonates Admitted in the Neonatal Intensive Care Unit: A Follow‐Up Cohort Study

“…The sample size was determined using the double population proportion difference formula by using predictor variable time to the initiation of enteral feeding from another study conducted in China. Time to the initiation of enteral feeding was considered a statistically significant independent predictor of time to reach full enteral feeding [ 26 ]. The sample size needed for this study was calculated using STATA version 16, considering the following statistical assumptions: two-sided significant level ( α ) of 5%, power 80%, Za/2 = Z value at 95% confidence interval = 1.96, hazard ratio (HR) = 1.52, the survival probability of event = 0.59, the proportion of withdrawal = 10% incomplete charts with a one-to-one allocation ratio of exposed to nonexposed was assumed.…”

Effects of pasteurization on osteopontin levels in human breastmilk and pasteurized breastmilk products

“…13,14,15 Although pasteurization is important to ensure breastmilk safety, discussion of the impacts of breastmilk sterilization has been on the rise. 16,17,18 Recently, attention has been drawn toward another bioactive milk component: osteopontin, which has been shown to play a role in infant immune and intestinal development. 19,20,21 Osteopontin is a highly phosphorylated glycoprotein that plays pleiotropic roles, including in cell adhesion, 22 immune cell modulation, 23 and prevention of calcification.…”

“…13,14,15 Although pasteurization is important to ensure breastmilk safety, discussion of the impacts of breastmilk sterilization has been on the rise. 16,17,18…”