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[Effect of different feeding initiation formulas on very low birth weight infants]
Xue-Mei Li1, Jing Jiang, Yan Wu
1Department of Pediatric Outpatient, Chongqing Maternal and Child Healthcare Hospital, Chongqing 401147, China. 6170882@qq.com.
Insights
Standard preterm formula (SPF) and extensively hydrolyzed protein formula (eHF) support growth in very low birth weight infants. Both formulas are safe for feeding initiation without increasing extrauterine growth retardation (EUGR) rates.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Clinical Pediatrics
Background:
- Very low birth weight (VLBW) infants (<1500g, <34 weeks gestational age) require specialized nutritional support.
- Feeding intolerance and extrauterine growth retardation (EUGR) are significant challenges in VLBW infant care.
- Optimizing feeding initiation strategies is crucial for VLBW infant outcomes.
Purpose of the Study:
- To compare the effects of standard preterm formula (SPF), extensively hydrolyzed protein formula (eHF), and breastfeeding on VLBW infant growth, development, and feeding tolerance.
- To evaluate the safety and efficacy of different feeding initiation formulas in preterm infants.
Main Methods:
- A prospective study involving 86 VLBW infants (<34 weeks GA, <1500g BW) randomized into three groups: SPF, eHF, and breastfeeding (control).
- Assessment of growth indices (weight, length, head circumference), feeding tolerance markers, blood biochemistry, and incidence of complications (NEC, sepsis, EUGR).
- Statistical analysis to compare outcomes between the feeding groups.
Main Results:
- No significant differences in growth indices, hospital stay duration, or EUGR rates were observed among the groups.
- SPF and eHF groups showed faster meconium to yellow stool transition compared to the control group.
- SPF group achieved standard enteral feeding faster than eHF and control groups.
- SPF group had lower serum prealbumin, while SPF and eHF groups had higher hemoglobin at discharge than controls.
- eHF group exhibited a lower percentage of eosinophils at discharge compared to the SPF group.
- Incidence rates of feeding intolerance, sepsis, and necrotizing enterocolitis (NEC) were similar across all groups.
Conclusions:
- Both extensively hydrolyzed protein formula (eHF) and standard preterm formula (SPF) are suitable for feeding initiation in very low birth weight preterm infants.
- These formulas can be used without increasing the risk of extrauterine growth retardation (EUGR).
- Further research may explore specific biochemical markers and immunological responses related to different formulas.
Objective:
To explore the effect of feeding initiation with different formulas on the growth, development, and feeding tolerance in very low birth weight infants.
Methods:
A total of 86 preterm infants with a gestational age of <34 weeks and a birth weight of <1 500 g were divided into three groups according to their feeding initiation formulas: standard preterm formula feeding group (SPF group; n=31), extensively hydrolyzed protein formula feeding group (eHF group; n=27), and breastfeeding group (control group; n=28). Comparisons were made between the groups in terms of growth indices, feeding condition, blood biochemistry, length of hospital stay, and incidence rates of feeding intolerance, sepsis, necrotizing enterocolitis (NEC), and extrauterine growth retardation (EUGR).
Results:
There were no significant differences among the above three groups in body weight, head circumference, and rate of increase in body length measured during hospitalization, as well as length of hospital stay and EUGR incidence rate at discharge (P>0.05). The SPF and eHF groups had a significantly shorter transition time from meconium to yellow stool than the control group (P<0.01). The SPF group had a significantly shorter time to standard enteral feeding than the eHF and control groups (P<0.01), with no significant difference observed between the latter two groups. The SPF group had a significantly lower serum prealbumin level than the eHF and control groups (P<0.01). The SPF and eHF groups had a significantly higher hemoglobin level at discharge than the control group (P<0.01). The percentage of eosinophils at discharge was significantly lower in the eHF group than in the SPF group (P<0.01). No significant differences were found among the three groups regarding the incidence rates of feeding intolerance, sepsis, and NEC (P>0.05).
Conclusions:
Both eHF and SPF can be used for feeding initiation for very low birth weight preterm infants with a gestational age of <34 weeks without increasing the incidence rate of EUGR.
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