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[Effects of extensively hydrolyzed protein formula on feeding and growth in preterm infants: a multicenter controlled
Mu-Xue Yu1, Si-Qi Zhuang, Dan-Hua Wang
1Department of Pediatrics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China. suesq@126.com.
Insights
Extensively hydrolyzed protein formula (eHF) improved gastrointestinal motility and bilirubin metabolism in preterm infants. This specialized infant formula did not increase the incidence of extrauterine growth retardation (EUGR).
Area of Science:
- Neonatal Nutrition
- Gastroenterology
- Pediatric Research
Context:
- Preterm infants often experience feeding difficulties and complications.
- Nutritional strategies are crucial for optimizing growth and development in vulnerable infants.
- The study investigated the impact of extensively hydrolyzed protein formula (eHF) in preterm infants.
Purpose:
- To evaluate the effects of eHF on feeding, growth, and clinical outcomes in preterm infants.
- To compare eHF with standard preterm formula (SPF) in two gestational age groups (<32 weeks and 32-34 weeks).
Summary:
- Infants <32 weeks fed eHF showed faster meconium evacuation and lower serum total bilirubin levels.
- Both preterm groups receiving eHF required more time to reach enteral nutrition goals and partial parenteral nutrition.
- No significant difference in extrauterine growth retardation (EUGR) incidence was observed between eHF and SPF groups at discharge.
Impact:
- eHF demonstrates benefits in improving gastrointestinal motility and accelerating bilirubin metabolism in preterm infants.
- The findings suggest eHF is a viable option for managing feeding issues in preterm neonates without compromising growth.
- This research contributes to evidence-based nutritional guidelines for preterm infant care.
Objective:
To study the effects of extensively hydrolyzed protein formula (eHF) on the feeding and growth in preterm infants through a multicenter controlled clinical study.
Methods:
Preterm infants admitted to eight upper first-class hospitals in China between February 2012 and December 2013 were randomly selected. They were divided into two observation groups and two control groups. The first observation group consisted of preterm infants with a gestational age of <32 weeks, who were fed with eHF for 10-14 days after birth and then with standard preterm formula (SPF) until discharge. The second observation group consisted of preterm infants with a gestational age of 32-34 weeks, who were fed with SPF after birth, but were switched to eHF (7-14 days) if suffering feeding intolerance at 6-8 days after birth. The two control groups with corresponding gestational ages kept to be fed with SPF after birth. Clinical data were recorded to compare feeding condition, physical growth, blood biochemical indices, and major complications between different groups.
Results:
A total of 328 preterm infants were enrolled. Preterm infants with a gestational age of <32 weeks in the observation group had a significantly shorter meconium evacuation time than in the corresponding control group (P<0.05). They also had significantly lower levels of serum total bilirubin at weeks 1 and 2 after birth compared with the control group (P<0.05). The observation group needed more time in reaching enteral nutrition (EN) basic energy uptake of 50 kcal/(kg·d), partial parenteral nutrition (PPN), hospitalization, and corrected gestational age at discharge compared with the controlled infants (P<0.05). There was no difference in the incidence of extrauterine growth retardation (EUGR) at discharge between the two groups (P>0.05). Preterm infants with a gestational age of 32-34 weeks in the observation group had significantly lower serum total bilirubin levels at 2 weeks after birth compared with the corresponding control group (P<0.05). They required more time in achieving EN basic energy and PPN than in the control group (P<0.05). There was no difference in the incidence of EUGR at discharge between the two groups (P>0.05).
Conclusions:
For preterm infants, eHF can improve gastrointestinal motility, accelerate bilirubin metabolism and excretion and does not increase the incidence of EUGR.
