The Effect of Early Limited Formula on Breastfeeding, Readmission, and Intestinal Microbiota: A Randomized Clinical...

Area of Science:

• Neonatal care
• Pediatric nutrition
• Microbiome research

Background:

• Infant weight loss is a common concern, often leading to formula supplementation.
• The impact of early, limited formula supplementation on breastfeeding outcomes and infant gut microbiota is not fully understood.

Purpose of the Study:

• To evaluate the effect of early limited formula (ELF) supplementation on breastfeeding duration, infant readmission rates, and intestinal microbiota composition up to one month of age.
• To determine if 10 mL of formula after each breastfeeding session, prior to mature milk production, influences these outcomes.

Main Methods:

• A randomized controlled trial involving 164 exclusively breastfeeding newborns (24-72 hours old) with weight loss ≥75th percentile.
• Infants were randomized to either ELF supplementation or exclusive breastfeeding (control).
• Outcomes including breastfeeding duration, readmission, and intestinal microbiota were assessed through 1 month post-birth.

Main Results:

• No significant difference in breastfeeding rates at 1 week (95.8% ELF vs. 93.5% control) or 1 month (86.5% ELF vs. 89.7% control) was observed.
• Readmission rates were lower in the ELF group (0%) compared to the control group (4.8%), though not statistically significant (P=0.06).
• ELF supplementation did not negatively affect the abundance of beneficial bacteria (Lactobacillus, Bifidobacterium) or promote harmful bacteria (Clostridium) in the infant gut.

Conclusions:

• Early limited formula supplementation in high-risk newborns does not interfere with breastfeeding at 1 month or alter intestinal microbiota.
• ELF may serve as a valuable therapeutic strategy to potentially decrease infant readmission rates.
• This approach supports continued breastfeeding without compromising the infant's gut microbiome development.