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Relationship Between Human Milk Feeding Patterns and Growth in the First Year of Life in Infants with Congenital
Jillian C Trabulsi1, Rachelle Lessen2, Kathryn Siemienski3
1Department of Behavioral Health and Nutrition, University of Delaware, 318 STAR Tower, 100 Discovery Blvd., Newark, DE, 19713, USA. trabulsi@udel.edu.
Insights
Human milk feeding patterns, alone or with formula, support growth in infants with congenital heart defects. This study found no significant differences in growth outcomes based on feeding patterns in the first year.
Area of Science:
- Pediatrics
- Neonatology
- Nutritional Science
Background:
- Infants with congenital heart defects (CHDs) often face feeding challenges and require specialized nutritional support.
- Understanding the impact of human milk feeding patterns on growth is crucial for optimizing care in this vulnerable population.
Purpose of the Study:
- To investigate the relationship between human milk feeding patterns and infant growth in the first year of life among infants with CHDs.
- To determine if different milk feeding strategies influence anthropometric outcomes in neonates undergoing or planning cardiac surgery.
Main Methods:
- A prospective cohort study involving infants (0-21 days) with CHDs, who were planned for neonatal surgery and whose mothers intended to provide human milk.
- Collection of anthropometric data (weight, length, head circumference) at nine time points (0.5 to 12 months) and conversion to Z-scores using WHO growth references.
- Cluster analysis to identify milk feeding patterns (human milk only, human milk with formula transition, formula transition) and general linear models to assess growth parameter changes over time.
Main Results:
- Three distinct milk feeding patterns were identified: exclusive human milk, human milk transitioning to mixed feeding, and human milk transitioning to formula.
- No statistically significant interaction effect between milk feeding pattern and time was observed on longitudinal changes in weight-for-age, length-for-age, weight-for-length, or head circumference-for-age Z-scores.
- Both exclusive human milk feeding and combined human milk and formula feeding supported age-appropriate growth in infants with CHDs.
Conclusions:
- Human milk feeding, whether exclusive or supplemented with infant formula, is associated with adequate growth in infants with congenital heart defects during their first year.
- The findings suggest that various human milk feeding patterns can support healthy development in infants with CHDs, reducing concerns about specific feeding transitions.
Abstract:
The purpose of this study was to determine the relationship between patterning of human milk feeding and growth of infants with congenital heart defects in the first year of life. Inclusion criteria for this prospective cohort study included infants 0-21 days, who had undergone or had planned neonatal corrective or palliative surgery prior to hospital discharge, and whose mothers planned to feed human milk. Data on anthropometric measures (weight, length, head circumference) and infant milk type (human milk, formula, other) were collected at nine time points (0.5, 1, 2, 3, 4, 6, 8, 10, 12 months). Anthropometric data were converted to weight-for-age, length-for-age, head circumference-for-age, and weight-for-length Z-scores using World Health Organization growth reference data. Cluster analysis identified three milk type feeding patterns in the first year: Infants fed human milk only with no formula supplementation, infants fed human milk who then transitioned to a mix of human milk and formula, and infants who fed human milk and transitioned to formula only. General linear models assessed the effect of milk type feeding patterns on growth parameters over time. No effect of milk type pattern × time was found on longitudinal changes in weight-for-age (p for interaction = 0.228), length-for-age (p for interaction = 0.173), weight-for-length (p for interaction = 0.507), or head circumference-for-age (p for interaction = 0.311) Z-scores. In this cohort study, human milk alone or combined with infant formula supported age-appropriate growth in infants with congenital heart defects in the first year.
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