Individualized Human Milk Fortification to Improve the Growth of Hospitalized Preterm Infants

Nutrition in Clinical Practice - Tập 35 Số 4 - Trang 680-688 - 2020
Meiying Quan1, Danhua Wang1, Lijuan Gou1, Zhi-Xing Sun1, Jingran Ma1, Lejia Zhang1, Chen Wang1, Kurt Schibler2, Zhenghong Li1
1Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
2Cincinnati Children's Hospital Medical center, Cincinnati, Ohio USA

Tóm tắt

AbstractBackgroundHuman milk (HM) is the first choice for preterm infants, but exclusive HM feeding is inadequate for the growth of very preterm infants. The hypothesis of this trial is that infants fed according to an individualized fortification regimen will have higher protein intake and improved weight gain velocity (WGV).MethodsA prospective, randomized, controlled study was conducted. Infants <34 weeks of gestational age were enrolled when enteral feeding volume reached 60 mL/kg/d and were randomly allocated to the individualized fortification (IF) group or the standard fortification group. The IF group was fed using a regimen that featured modifying HM fortifier and supplemental protein powder based on the protein concentration in HM, current body weight of infants, and blood urea nitrogen (fortification level was set as L−1, L0, L1, L2, L3; the amount of HM fortifier and protein powder were determined accordingly).ResultsBetween September 2012 and August 2016, 51 preterm infants completed the study. In the IF group, 62.5% (15/24) of preterm infants were fed with HM fortified to level 1, 29.2% (7/24) to level 2, and 12.5% (3/24) to level 3. The WGV of the third week in the IF group was greater than the standard group (20.8 ± 7.9 vs 14.9 ± 4.5 g/kg/d, P = 0.022).ConclusionAbout two‐thirds of preterm infants needed to adjust the HM fortification to a higher level. The WGV of infants in the IF group was better than that of the standard group in the third week of this study.

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Tài liệu tham khảo

10.1515/jpm.2010.073

10.1016/j.earlhumdev.2010.04.001

10.1097/ANC.0000000000000108

10.1016/j.earlhumdev.2013.08.015

10.1097/00005176-199909000-00017

10.1097/00005176-199310000-00009

10.1177/0884533615596508

10.3390/nu7042297

10.1542/peds.2004-1699

10.1097/MCO.0000000000000167

10.3233/NPM-1373113

10.1038/jp.2009.50

10.1136/archdischild-2013-304422

10.1186/1471-2431-13-178

10.1038/sj.jp.7211571

10.1097/00005176-199502000-00005

10.1177/0890334413517941

10.1177/0890334415588513

10.1038/jp.2017.52

10.1016/j.jpeds.2013.04.052

10.1097/MPG.0b013e3181adaee0

Pediatrics Group of the Parenteral and Enteral Nutrition Branch of Chinese Medical Association, 2013, Guidelines for clinical application of neonatal nutritional support in China, Chinese J Pediatr Surg, 34, 782

10.1080/16070658.2016.1217646

10.1097/MPG.0b013e3182a208c7

1976, Pediatrics, 57, 278, 10.1542/peds.57.2.278

10.1136/adc.2011.300492

Santulli TV, 1975, Acute necrotizing enterocolitis in infancy: a review of 64 cases, Pediatrics, 55, 376, 10.1542/peds.55.3.376