Supplementation of Mother’s Own Milk with Preterm Donor Human Milk: Impact on Protein Intake and Growth in Very Low Birth Weight Infants—A Randomized Controlled Study

Abstract

This randomized study investigates whether feeding very low birth weight (VLBW) infants with mother’s own milk (MOM) supplemented with either preterm (PDM) or term donor milk (TDM), when MOM is insufficient, has a positive impact on infants’ protein intake and growth. A hundred and twenty VLBW infants were randomized into two groups. Group A (43 infants) received MOM supplemented with PDM, whereas Group B (77 infants) was fed with MOM supplemented with TDM, for the first three weeks of life (donor milk period). Breast milk fortifier was added when milk feeds exceeded 50 mL/Kg/day. After the donor milk period, both groups were fed with formula when MOM was not available or the milk bank was unable to provide TDM. Protein intake was higher in Group A than in Group B at initiation of milk fortification (p = 0.006), as well as during the 3-week donor milk period (p = 0.023) and throughout hospitalization (p = 0.014). Moreover, Group A presented higher Δz-score for body weight (p = 0.019) and head circumference (p = 0.001) from birth to the end of donor milk period, and higher mean body weight at discharge (p = 0.047) compared to Group B. In conclusion, when donor milk is required, PDM positively impacts protein intake and growth in VLBW infants (NCT05675397).

The Impact of Breastfeeding on Child Neurological Development: Clinical Implications of Breastfeeding on Child Neurological Development

“…Breast milk is rich in bioactive factors such as microRNAs (miRNAs), long non-coding RNAs (lncRNAs), stem cells and microbiome, all of which play a crucial role in infant neurodevelopment. MiRNAs regulate gene expression, lncRNAs protect against brain damage, oxidative stress and inflammation, while the microbiome contributes to the baby's epigenetics and neurodevelopment (GIALELI et al, 2023). Possible long-term neurological effects due to lack of exclusive breastfeeding include attention deficit hyperactivity disorder, autism, cerebral palsy, cognitive and developmental delay, epilepsy, hearing impairment, kernicterus, language disorder, mood swings, lower IQ and specific learning disorder.…”

Influence of epigenetics and microbiota in early‑life development: A possible role for exosomes (Review)

“…Additionally, HBM-derived exosomes can cross the blood-brain barrier and can thus influence neuronal function. Several ncRNAs found in exosomes possibly act on genes implicated in brain development and function, thus acting as epigenetic regulators of proper brain development (100). such an example is let-7a, a miRNA found in HBM-derived exosomes that influences both immune response by downregulating IL-6 secretion and brain development by regulating neural cell proliferation and differentiation (100,101).…”

“…Several ncRNAs found in exosomes possibly act on genes implicated in brain development and function, thus acting as epigenetic regulators of proper brain development (100). such an example is let-7a, a miRNA found in HBM-derived exosomes that influences both immune response by downregulating IL-6 secretion and brain development by regulating neural cell proliferation and differentiation (100,101). Translational studies have also shown that HBM-derived exosomes control DNMT1 expression which is involved in the upregulation of metabolism-related genes, such as insulin (102).…”