Hydrolysed milk in preterm infants: An open problem

Zuppa, Antonio Alberto; Visintini, F; Cota, Francesco; Maggio, Luca; Romagnoli, Costantino; Tortorolo, Giuseppe Gio Batta

doi:10.1080/08035320510043600

Cited by 10 publications

(5 citation statements)

References 14 publications

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“…Rigo et al [ 31 ] and Szajewska et al [ 32 ] reported about the nutritional insufficiency of hydrolyzed protein formula for term and preterm infants. Zuppa et al [ 33 ] also had the same question in their study. In the present study, the patients with FI who switched to AAF for a short termdid not develop any adverse clinical sign or symptom during AAF feeding, and it showed improvement in the symptoms and signs of FI with proper body weight gain.…”

Section: Discussionmentioning

confidence: 76%

Amino Acid-Based Formula in Premature Infants with Feeding Intolerance: Comparison of Fecal Calprotectin Level

Jang

Park

Kim

et al. 2018

Pediatr Gastroenterol Hepatol Nutr

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PurposeWe investigated fecal calprotectin (FC) levels in preterm infants with and without feeding intolerance (FI), and compared the FC levels according to the type of feeding.MethodsThe medical records of 67 premature infants were reviewed retrospectively. The fully enteral-fed infants were classified into two groups; the FI group (29 infants) and the control group (31 infants). Seven infants with necrotizing enterocolitis, sepsis, and perinatal asphyxia were excluded. If breast milk (BM) or preterm formula (PF) could not be tolerated by infants with FI, amino acid-based formula (AAF) was tried temporarily. Once FI improved, AAF was discontinued, and BM or PF was resumed. We investigated the FC levels according to the type of feeding.ResultsSignificant differences were found in gestational age, birth weight, age when full enteral feeding was achieved, and hospital stay between the FI and control group (p<0.05). The FC levels in the FI group were significantly higher than those in the control group (p<0.05). The FC levels in the AAF-fed infants with FI were significantly lower than those in the BM- or PF-fed infants (p<0.05). The growth velocities (g/d) and z scores were not significantly different between the FI and control group (p>0.05).ConclusionThe FC levels in AAF-fed infants with FI showed significantly lower than those in the BM- or PF-fed infants with FI. The mitigation of gut inflammation through the decrease of FC levels in AAF-fed infants with FI could be presumed.

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Section: Discussionmentioning

confidence: 76%

Amino Acid-Based Formula in Premature Infants with Feeding Intolerance: Comparison of Fecal Calprotectin Level

Jang

Park

Kim

et al. 2018

Pediatr Gastroenterol Hepatol Nutr

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“…Data from Mihatsch et al 3 suggest that time to full enteral feeds is shorter when infants are fed a HW infant formula but its' use is tempered by concerns for nutritional adequacy. 4,22 Data from this study suggest that a pHW formula can be fed from the beginning without such concerns, a critical consideration in the early establishment of adequate enteral intakes in these underfed infants.…”

Section: Discussionmentioning

confidence: 87%

Growth in preterm infants fed either a partially hydrolyzed whey or an intact casein/whey preterm infant formula

et al. 2008

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Objective: To compare feeding tolerance, nutrient intake and growth in preterm infants (p32 weeks, p1750 g) fed either a standard nonhydrolyzed whey-casein (nHWC) or a partially hydrolyzed whey (pHW) preterm infant formula.Study Design: In this double-blind randomized controlled trial infants were fed either formula for at least 3 weeks. Intake was monitored daily, serum chemistries and growth weekly. Data were analyzed using analysis of covariance.Result: A total of 80 infants were enrolled, 72 completed the study. No differences were noted in demographic characteristics. No differences were detected in feeding tolerance, intakes (118 ± 21 vs 119 ± 14; nHWC vs pHW) or growth weight, 28 ± 1.5 vs 28 ± 1.6 g per day; length, 1.0 ± 0.7 vs 1.0±0.6 cm per week; head circumference, 0.9±0.4 vs 1.0±0.44 cm per week). At the end of study, blood urea nitrogen (5.2 ± 3.1 <6.7±2.3 mg per 100 ml, nHWC4.4 ± 0.5 g per 100 ml) and albumin (2.7 ± 0.3 >2.6 ± 0.4 g per 100 ml) differed. Conclusion:A pHW preterm infant formula was not associated with improved feeding tolerance, enteral intake or growth but differences in serum chemistries. These are unlikely to be clinically relevant because values were well within normal limits for preterm infants, whereas growth was identical in both groups and paralleled that 'in utero'.

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“…If there are possible nutritional benefits for using EHF for feeding infants after NEC, they should be weighed against possible disadvantages. 21 Indeed, these formulas have an energy density close to that of term formulas, in addition to usually low mineral and polyunsaturated fatty acid contents as compared with preterm formulas. Urinary nitrogen excretion is higher, 22 and calcium and phosphorus absorption and nitrogen retention are lower in preterm infants fed with hydrolysed formula compared with those fed with whole protein formula.…”

Section: Discussionmentioning

confidence: 93%

Use of extensively hydrolysed formula for refeeding neonates postnecrotising enterocolitis: a nationwide survey-based, cross-sectional study

et al. 2016

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ObjectiveTo evaluate the prevalence of and reasons for using extensively hydrolysed formulas (EHFs) of cow's milk proteins in the French neonatal units as well as the modality of their prescription for refeeding infants recovering from necrotising enterocolitis (NEC).MethodsA multicentre nationwide cross-sectional study using a questionnaire to address the prevalence of use and the reasons for prescribing EHF in hospitalised neonates and to examine the protocols and the actual reasons for their use for refeeding infants in recovery from NEC. The questionnaire was sent to only 1 senior neonatologist in each neonatal unit included in the study.ResultsMore than half of the French neonatal units participated in the survey. 91% of the surveyed units used EHF. Of 1969 infants hospitalised on the day the survey was run, 12% were fed on an EHF. 11% of the EHF prescriptions were due to previous NEC. The main reasons for using an EHF to feed infants post-NEC were the absence of human milk (75%) and surgical management of NEC (17%). When given, EHF was mainly prescribed for a period varying between 15 days and 3 months. None of the involved units continued using the EHF after 6 months of age. More than half of the surveyed units acknowledged hospitalising infants for the initiation of weaning EHF but only 21% of them tested these infants for cow's milk allergy.ConclusionsThe prevalence of EHF use in the French neonatal units is high. Refeeding infants post-NEC is one of the main reasons for such a high prevalence. The main incentive for using an EHF is the absence of human breast milk, either maternal or donor.

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Hydrolysed milk in preterm infants: An open problem

Abstract: Further investigations addressing protein and mineral metabolism as well as long-term effects, including neurodevelopment, are needed.

Cited by 10 publications

References 14 publications

Amino Acid-Based Formula in Premature Infants with Feeding Intolerance: Comparison of Fecal Calprotectin Level

Amino Acid-Based Formula in Premature Infants with Feeding Intolerance: Comparison of Fecal Calprotectin Level

Growth in preterm infants fed either a partially hydrolyzed whey or an intact casein/whey preterm infant formula

Use of extensively hydrolysed formula for refeeding neonates postnecrotising enterocolitis: a nationwide survey-based, cross-sectional study

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