Human milk-derived fortifiers are linked with feed extension due to Hypoglycemia in infants &lt;1250 g or &lt;30 weeks: a matched retrospective chart review

Ackley, Danielle; Wang, Hongyue; D’Angio, Carl T.; Meyers, Jeffrey; Young, Bridget E.

doi:10.1038/s41372-023-01654-z

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…Feed extension also occurred predominantly in infants fed HMDF. (27) Our study showed that all infants with BG levels less than 50 mg/dL and 92% (11/12) of the infants requiring intervention for hypoglycemia were in the HMDF group. Risk factors for hypoglycemia in preterm infants <32 weeks include SGA, intrauterine growth restriction, maternal hypertension and antenatal steroid administration.…”

Section: Accepted Manuscriptmentioning

confidence: 48%

Transient Hypoglycemia and Biochemical Differences in Infants Less Than 1,250 G at Birth Fed Human Milk with Human Milk–Derived Fortifier versus Cow Milk–Derived Fortifier

Chang,

Tetarbe,

Barton

et al. 2023

Am J Perinatol

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Objective: Fortification of human milk with either human milk-derived fortifier (HMDF) or cow milk-derived fortifier (CMDF) is important in preterm infants. Objective is to compare the incidence of hypoglycemia, and biochemical values in infants less than 1250g at birth fed HMDF versus CMDF. Study design: Retrospective cohort study on infants less than 1250g at birth who were fed with HMDF or CMDF. Hypoglycemia was defined as blood glucose (BG) level equal to or less than 60 mg/dL within 72 hours of full enteral feeds when off TPN and intravenous fluids. Results: Ninety infants were enrolled (HMDF=61; CMDF=29). HMDF group had a higher rate of hypoglycemia (46% vs. 24%; p=0.048) after achievement of full enteral feeding. The median minimum blood glucose (BG) was lower (61 vs. 71; p=<0.01); while blood urea nitrogen (12 vs. 6; p=<0.01); and albumin (3.1 vs. 2.7; p=<0.01) were higher in HMDF group compared to CMDF. Conclusions: At full enteral feedings in infants less than 1250g at birth, a HMDF diet may predispose to hypoglycemia needing intervention. Close monitoring of BG levels once off parenteral nutrition is recommended.

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Section: Accepted Manuscriptmentioning

confidence: 48%

Transient Hypoglycemia and Biochemical Differences in Infants Less Than 1,250 G at Birth Fed Human Milk with Human Milk–Derived Fortifier versus Cow Milk–Derived Fortifier

Chang,

Tetarbe,

Barton

et al. 2023

Am J Perinatol

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Human milk derived fortifiers are associated with glucose, phosphorus, and calcium derangements

Ackley,

Yin,

D’Angio

et al. 2024

J Perinatol

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Point-of-care human milk concentration by passive osmosis: comprehensive analysis of fresh human milk samples

Schinkel,

Nelson,

Kim

et al. 2024

J Perinatol

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Objective Preterm infants need enrichment of human milk (HM) for optimal growth. This study evaluated a novel, point-of-care human milk concentration (HMC) process for water removal from fresh HM samples by passive osmotic concentration. Study design Nineteen fresh HM samples were concentrated by incubation with the HMC devices for 3 h at 4 °C. Pre- and post-concentration HM samples were compared by HM properties for: pH, osmolality, macronutrients, enzyme activity, bioactive, and total cell viability. Results Passive osmotic concentration reduced HM volume by an average of 16.3% ± 3.8% without a significant effect on pH or cell viability. Ten of the 41 HM components did not differ significantly (p > 0.05) between pre- and post-concentration samples. Twenty-three increased within the expected range by volume reduction. Six increased more than expected, two less than expected, and none decreased significantly. Conclusion Passive osmotic concentration of fresh HM can concentrate HM components by selective removal of water. HM osmolality and pH remained within neonatal feeding parameters.

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Human milk-derived fortifiers are linked with feed extension due to Hypoglycemia in infants <1250 g or <30 weeks: a matched retrospective chart review

Cited by 3 publications

References 21 publications

Transient Hypoglycemia and Biochemical Differences in Infants Less Than 1,250 G at Birth Fed Human Milk with Human Milk–Derived Fortifier versus Cow Milk–Derived Fortifier

Transient Hypoglycemia and Biochemical Differences in Infants Less Than 1,250 G at Birth Fed Human Milk with Human Milk–Derived Fortifier versus Cow Milk–Derived Fortifier

Human milk derived fortifiers are associated with glucose, phosphorus, and calcium derangements

Point-of-care human milk concentration by passive osmosis: comprehensive analysis of fresh human milk samples

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