Allergic diseases among very preterm infants according to nutrition after hospital discharge

Area of Science:

• Neonatal nutrition
• Allergy and immunology
• Pediatric gastroenterology

Background:

• Very preterm infants (VPI) are at high risk for allergic diseases.
• Nutritional strategies post-discharge may influence allergy development.

Purpose of the Study:

• To investigate if cow's milk-based human milk fortifier (HMF) or preterm formula increases allergic disease incidence in VPI compared to exclusive breastfeeding.
• To assess the impact of nutritional interventions on allergic outcomes up to 12 months corrected age.

Main Methods:

• A cohort of 324 VPI (24-32 weeks gestational age) were randomized post-discharge.
• Intervention groups received either fortified breast milk (HMF) or preterm formula; control group received exclusive breastfeeding.
• Follow-up at 4 and 12 months corrected age included allergy assessments (recurrent wheezing, atopic dermatitis, specific IgE).

Main Results:

• The incidence of recurrent wheezing was 39.2% and atopic dermatitis was 18.0% during the study period.
• Pre-existing allergic predisposition, male sex increased risk for atopic dermatitis and recurrent wheezing, respectively.
• No significant difference in allergic disease incidence was observed between the exclusively breastfed group and those receiving HMF or preterm formula.

Conclusions:

• Post-discharge nutritional supplementation with cow's milk-based HMF or preterm formula does not elevate the risk of allergic diseases in very preterm infants.
• Early nutritional choices in VPI do not appear to impact the development of common allergic conditions within the first year of life.