Beneficial Effects of Breast Milk in the Neonatal Intensive Care Unit on the Developmental Outcome of Extremely Low Birth Weight Infants at 18 Months of Age

Vohr, Betty R.; Poindexter, Brenda B.; Dusick, Anna M.; McKinley, Leslie T.; Wright, Linda L.; Langer, John; Poole, W. Kenneth

doi:10.1542/peds.2005-2382

Cited by 480 publications

(347 citation statements)

References 48 publications

Supporting

Mentioning

313

Contrasting

Unclassified

Order By: Relevance

“…[3][4][5] Other suggested benefits include decreased length of hospital stay and improved neurodevelopmental outcomes. 6,7 Providing breast milk to the VLBW infant is a challenging experience for many mothers, as it is fraught with numerous obstacles. For various reasons, the number of mothers of VLBW infants who initiate breastfeeding is substantially lower than mothers of term infants, 8 and these mothers are likely to discontinue breastfeeding or providing breast milk much earlier than mothers of term infants.…”

Section: Introductionmentioning

confidence: 99%

Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study

et al. 2011

View full text Add to dashboard Cite

Objective: The purpose of this randomized pilot study was to collect preliminary data regarding the feasibility and effects of early initiation of milk expression on the onset of lactogenesis stage II and milk volume in mothers of very low birth weight (VLBW) infants.Study Design: Twenty women were randomized to initiate milk expression within 60 min (group 1) or 1 to 6 h (group 2) following delivery. Milk volume and timing of lactogenesis stage II was compared between groups using Wilcoxon's rank sum tests.Result: Group 1 produced statistically significantly more milk than group 2 during the first 7 days (P ¼ 0.05) and at week 3 (P ¼ 0.01). Group 1 also demonstrated a significantly earlier lactogenesis stage II (P ¼ 0.03). Conclusion:Initiation of milk expression within 1 h following delivery increases milk volume and decreases time to lactogenesis stage II in mothers of VLBW infants.

show abstract

Section: Introductionmentioning

confidence: 99%

Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study

et al. 2011

View full text Add to dashboard Cite

show abstract

“…[8][9][10][11][12] Therefore, it is the preferred feeding for preterm infants. However, human milk does not provide all the nutrients that preterm infants need, which is why human milk fed to preterm infants must be supplemented (fortified) with nutrients.…”

Section: Introductionmentioning

confidence: 99%

Preterm infants fed fortified human milk receive less protein than they need

2009

View full text Add to dashboard Cite

Objective: The aim of this study was to compare the actual nutrient intakes observed in a previously reported study with assumed nutrient intakes based on the customary assumptions about the composition of human milk.Study Design: Fortified human milk is assumed to provide adequate amounts of nutrients for premature infants. This assumption holds if milk has the composition of milk expressed by mothers of premature infants during weeks 2 to 3 of lactation. The assumption does not necessarily hold for milk expressed after 2 to 3 weeks lactation. It also does not hold for donor milk, which is typically provided by mothers of term infants. The size of the disparity between assumed and actual nutrient intakes is not known. Actual nutrient intakes were available for 32 preterm infants participating in the study. Assumed nutrient intakes were calculated for these infants by substituting assumed nutrient concentrations for observed nutrient concentrations. Data were compared separately for each of the 3 study weeks.Result: Actual protein intakes were significantly and consistently lower than assumed protein intakes during each study week. The differences in mean intakes were large, ranging from 0.5 to 0.8 g kg À1 per day. Differences in energy intake were small and not consistently significant.Conclusion: Actual intakes of protein by preterm infants fed fortified human milk are substantially lower than assumed intakes. The discrepancy may in part explain why preterm infants frequently show postnatal growth failure.

show abstract

“…The percentage of infants who receive HM exclusively varies widely in the United States; nearly 75% receive some breast milk, with 30% still receiving HM at discharge. 8 VLBW infants who are not fed HM are fed iron-fortified (12 to 15 mg/L ferrous sulfate) formula from the very first feed. In addition, these infants receive iron supplements (3 to 6 mg/kg/day or more of ferrous sulfate), even though the recommended dose of iron is 2 to 3 mg/kg/day from age 8 weeks.…”

Section: To the Editormentioning

confidence: 99%

Iron supplements and oxidative stress in very low birth weight infants

Raghuveer

Buettner

2008

The Journal of Pediatrics

View full text Add to dashboard Cite

We congratulate Braekke et al on their recent report. 1 The practice in Norway of administering iron supplementation to very low birth weight (VLBW) infants with 18 mg/day of ferrous fumarate from age 6 weeks is based on a 1955 study of 26 infants by Gairdner et al, 2 in which 50% received 60 mg of ferrous sulfate 3 times a day from age 2 or 3 weeks and 50% received the same dose of iron when their hemoglobin level fell to 11 g/100 mL. Gairdner et al concluded that iron supplements given to VLBW infants starting at age 3 weeks could mitigate anemia.Today, VLBW infants who survive are more premature, have poorer antioxidant defense systems, 3,4 and receive more red cell transfusions. Braekke et al have correctly raised the question of whether it is wise practice to continue high iron supplementation in VLBW infants. We would like to comment on whether their findings should affect the clinical care of VLBW infants in the United States.Braekke et al studied healthy and stable VLBW infants with a median weight of 1785 g at age 5 weeks. They excluded infants requiring >30% oxygen and/or mechanical ventilation. However, it is the "sick" and unstable VLBW infants who are at higher risk for developing severe bronchopulmonary dysplasia, necrotizing enterocolitis, and retinopathy of prematurity. Oxidative stress contributes to each of these morbidities. 5 Administration of ferrous iron, which can initiate the oxidation cascade, 6 may result in overloaded antioxidation capacity. Studies of these sick and unstable infants are needed to provide information on oxidative stress due to iron supplementation.The authors draw their conclusions based on 1 week of iron supplementation. The question remains open as to whether oxidative stress from high doses of iron supplements would increase with longer exposure periods that reflect real life situations.In this study, the median plasma ferritin level dropped from 84 to 59 µg/L between weeks 5 and 6 and increased to 63 µg/L by the end of week 7. None of the infants had iron-deficiency anemia, defined as plasma ferritin level <10 µg/L. 7 Most of the infants with birth weight <1000 g had received red cell transfusions, which resulted in higher serum ferritin levels before the initiation of iron supplementation. Thus, the risk of iron-deficiency anemia in HHS Public Access

show abstract

Beneficial Effects of Breast Milk in the Neonatal Intensive Care Unit on the Developmental Outcome of Extremely Low Birth Weight Infants at 18 Months of Age

Cited by 480 publications

References 48 publications

Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study

Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study

Preterm infants fed fortified human milk receive less protein than they need

Iron supplements and oxidative stress in very low birth weight infants

Contact Info

Product

Resources

About