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Effect of Nutritional Intake on the Body Composition of HIV-Exposed and HIV-Unexposed Preterm and Low Birth Weight
Klara McClunan1, Daniel Gerhardus Nel2,3, Muhammad Ali Dhansay4
11 Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Insights
Human breast milk (HBM) is often insufficient for very low birth weight (VLBW) infants. Fortified HBM showed significant body composition differences in HIV-exposed versus unexposed infants, while NPO infants had altered fat and fat-free mass.
Area of Science:
- Neonatal nutrition
- Pediatric body composition analysis
- Human breast milk research
Background:
- Human breast milk (HBM) may not meet the protein needs of very low birth weight (VLBW) infants, potentially impacting their body composition.
- Understanding the impact of HBM on infant body composition is crucial for optimizing growth and development.
Purpose of the Study:
- To assess the effect of HBM on the body composition of preterm VLBW infants, considering HIV exposure.
- To evaluate the influence of breast milk fortification and nil per os (NPO) duration on infant body composition.
Main Methods:
- A descriptive cross-sectional study included preterm infants with a birth weight of ≤1,200g.
- Nutritional intake and body composition were monitored over a 28-day follow-up period.
- Infants received either HBM or fortified HBM, with data analyzed based on HIV exposure and NPO status.
Main Results:
- No significant body composition differences were found between infants receiving HBM versus fortified HBM.
- Significant differences in fat mass percentage (FM%) and fat-free mass percentage (FFM%) were observed between HIV-exposed and unexposed infants receiving fortified HBM.
- Infants kept NPO showed significant differences in FM% and FFM% compared to those not kept NPO.
Conclusions:
- While HBM fortification did not alter overall body composition, HIV exposure status influenced outcomes in infants receiving fortified HBM.
- Nil per os (NPO) status was associated with smaller size and altered body composition (lower FM%, higher FFM%).
- Further research is needed to optimize nutritional strategies for VLBW infants based on HIV status and feeding protocols.
Background:
Human breast milk (HBM) is considered inadequate in meeting protein requirements, especially for very low birth weight (VLBW) infants, which could affect body composition.
Objectives:
The primary objective was to determine the effect of HBM on body composition of HIV-exposed and unexposed preterm VLBW and extremely low birth weight infants. The secondary objectives were to ascertain the effect breast milk fortification and days nil per os (NPO) have on body composition.
Materials And Methods:
A descriptive cross-sectional study was conducted. Preterm infants with a birth weight of ≤1,200 g were included. Infant nutritional intakes and body composition measurements were recorded during the 28-day follow-up period.
Results:
One hundred ten of 113 preterm infants received HBM and 91 infants received fortified HBM. HIV-exposed and unexposed infants receiving fortified HBM displayed differences in fat mass percentage (FM%) (0.88% versus 1.36%, p = 0.01; 0.97% versus 1.49%, p = 0.03) and fat-free mass percentage (FFM%) (98.98% versus 98.68%, p = 0.03; 99.02% versus 98.49%, p = 0.02) on days 21 and 28, respectively. Infants kept NPO displayed differences in FM% on days 7, 21, and 28 (0.9% versus 1.3%, p = 0.03; 0.99% versus 1.4%, p = 0.02; and 0.9% versus 1.6%, p = 0.0004) as well as differences in FFM% (99.1% versus 98.4%; p = 0.0005) on day 28 of life.
Conclusion:
There were no significant differences in the body composition of infants who received HBM versus fortified HBM. However, significant differences in body composition were reported between HIV exposure groups for infants who received fortified HBM. Infants who were kept NPO were generally smaller, shorter, and had lower FM% and more FFM%.
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