Clinical Findings According to Feeding Diets in Very Low Birth Weight Infants: Human Breast Milk versus Bovine Milk-Based Formula

Abstract

Purpose: We aimed to compare the clinical findings, including morbidity, duration of parenteral nutrition, and length of hospital stay between very low birth weight infants (VLBWIs) fed bovine milk-based formula (BOV) and VLBWIs fed human breast milk (HBM) in a neonatal intensive care unit (NICU). Methods: VLBWIs admitted to the NICU of Dongsan Medical Center, Keimyung University, were enrolled. Infants born from March to August 2014 (n=28) were fed BOV (the BOV group), and those born from September to December 2014 (n=18) were fed HBM (the HBM group). Pasteurized (heating at 62.5˚C for 30 minutes) donor human milk was used if the mother's own milk was not available because of insufficient breast milk production. Results: The gestational age (28.0±1.7 weeks vs. 27.8±1.4 weeks) and birth weight (1,055±265 g vs. 1,175±187 g), of the infants in the BOV and HBM, groups were similar. In addition, perinatal characteristics were similar between the groups. The dura tion of parenteral nutrition (36.4 days vs. 24.1 days, P=0.038), length of hospital stay (74.3 days vs.61.1 days, P=0.037), and incidence of nosocomial sepsis (53.6% vs. 22.2%, P= 0.035), significantly differed between the BOV and HBM groups. Further more, the frequency of feeding intolerance was higher in the BOV group than in the HBM group, but this difference was not significant. Perinatal cytomegalovirus infec tion was not detected in any of the infants fed pasteurized donor human milk. Conclusion: Human-breast-milk-based diet for VLBWIs significantly reduces the inci dence of nosocomial sepsis, duration of parenteral nutrition, and length of hospital stay.

Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

“…When these 3 studies were pooled, meta-analysis showed a significant protective effect of DHM on BPD36 (RR 0.80, 95% CI 0.68 to 0.95, p = 0.009). This protective effect of DHM on BPD36 was also observed when the 5 studies [20,32,35,36,38] that did not use DHM-based fortifier were pooled (RR 0.71, 95% CI 0.53 to 0.95, p = 0.022) and when the 8 studies were combined in a mixed-effects meta-analysis (RR 0.78, 95% CI 0.67 to 0.89, p = 0.0005, Figure 2). The study of Ginovart et al [32] also reported data on BPD28, and found no significant difference in this outcome between the group receiving DHM and the group receiving PF (RR 1.18, 95% CI 0.68 to 2.05, p = 0.560).…”

“…Based on the titles and abstracts of 1081 citations, we identified 139 potentially relevant studies ( Figure 1), 18 of which met the inclusion criteria [9,20,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. The main characteristics of the included studies are shown in Table 1.…”

“…The main characteristics of the included studies are shown in Table 1. Seven studies [9,29,30,37,39,40,42] were RCTs and 11 studies [20,27,28,[31][32][33][34]36,38,41,43] were observational. Definitions of feeding type varied across studies.…”

“…Eight observational studies compared infants receiving MOM supplemented with DHM to infants receiving MOM supplemented with PF [20,27,28,32,[34][35][36]38] of which all reported data on BPD36. Three of these studies [27,28,34] used a DHM-based fortifier in the DHM-group, and a bovine milk-based fortifier in the PF group.…”

“…The study of Ginovart et al [32] also reported data on BPD28, and found no significant difference in this outcome between the group receiving DHM and the group receiving PF (RR 1.18, 95% CI 0.68 to 2.05, p = 0.560). Four studies [20,32,34,36] reported data on mean days on mechanical ventilation, and meta-analysis showed a significant reduction in difference in means in the DHM-group (MD 2.14 days, 95% CI -4.08 to -0.21, p = 0.030, Figure 5). Three studies [20,32,36] reported data mean on days on oxygen, and meta-analysis could not find a significant difference in mean days on oxygen in the DHM group (MD -2.78 days, 95% CI -6.32 to 0.76, p = 0.123, Figure 6).…”