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Effect of Fortified Human Milk on the Growth Parameters of Babies With Very Low Birth Weight
Ali Amjad1, Abdul Rehman1, Afaq Hussain1
1Department of Neonatology, The Children's Hospital & The Institute of Child Health, Multan, PAK.
Insights
Preterm formula significantly improved weight gain in very low birth-weight infants compared to human milk fortifiers or olive oil. Preterm formula and human milk fortifiers enhanced growth parameters in neonates.
Area of Science:
- Neonatal nutrition
- Pediatric growth and development
- Clinical nutrition
Background:
- Very low birth-weight (VLBW) infants require specialized nutrition for optimal growth.
- Human milk fortification is a common practice, but alternative methods are explored.
- Assessing growth parameters and tolerance is crucial for VLBW infant care.
Purpose of the Study:
- To evaluate the impact of fortified human milk, preterm formula, and olive oil supplementation on VLBW infant growth.
- To compare weight gain, length gain, and head circumference among different feeding strategies.
- To assess digestive intolerance and electrolyte balance in VLBW infants receiving varied nutritional interventions.
Main Methods:
- A randomized controlled trial involving VLBW infants in a neonatal intensive care unit (NICU).
- Three groups received: 1) Human milk + Human Milk Fortifier (HMF), 2) Human milk + Preterm Formula, 3) Human milk + Olive Oil.
- Growth parameters, digestive intolerance, sepsis, hospital stay, and electrolyte levels were monitored and analyzed using Pearson's chi-square and ANOVA.
Main Results:
- Preterm formula supplementation resulted in significantly higher weight gain compared to HMF and olive oil (p=0.001).
- Olive oil supplementation led to a significantly lower head circumference (p=0.000) and higher feeding intolerance and electrolyte imbalance (p=0.020, p=0.024).
- No significant differences were noted for length gain across groups.
Conclusions:
- Preterm formula is beneficial for enhancing weight gain and overall growth in VLBW infants.
- Human milk fortifiers also support growth, though potentially less effectively than preterm formula for weight gain.
- Olive oil supplementation may increase risks of feeding intolerance and electrolyte imbalance in VLBW infants.
Abstract:
Objective The objective of this study is to assess the effect of fortified human milk on growth parameters of very low birth-weight babies. Study place and duration This randomized controlled trial took place at the neonatal intensive care unit (NICU), Children's Hospital, and Institute of Child Health in Multan from the 1st of January 2020 to the 1st of July 2021. Material and methods In group I, 25ml human milk was fortified with a 1g human milk fortifier (HMF) sachet (1g of HMF gives 4kcal added to 25ml of human milk). In group II, newborns were fed preterm formula (493 kcal/100 g where 0.8 g=4 kcal added to 25 ml of human milk) mixed with human milk. Infants were administered human milk + olive oil (0.4 mL = 4Kcal per 25ml human milk) in group III. Everyday weight gain, digestive intolerance (vomiting and/or abdominal distension), sepsis, hospital stay, electrolyte imbalance (derangement of serum sodium, potassium, chloride, and magnesium levels), albumin, and cholesterol/triglyceride levels were assessed. The data was analyzed through descriptive and inferential means using Pearson's chi-square tests and one-way analysis of variance (ANOVA). Results Results indicate that preterm formula infants gain higher weight compared to human fortifier infants and olive oil. Similarly, the difference was statistically significant (p=0.001). However, olive oil infants gained a lower head circumference compared to the other two groups, and the difference was statistically significant as well (p=0.000). Moreover, feeding intolerance and electrolyte imbalance were higher in olive oil infants, p=0.020 and p=0.024, respectively. Conclusion It can be concluded that the use of and preterm formula can prove beneficial in increasing the growth rate in terms of weight gain, length gain, and head circumference.
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