Related Experiment Videos
[Feeding very small premature infants with concentrated breast milk]
Insights
Concentrated breast milk provides adequate nutrition for premature infants, supporting growth and reducing mortality compared to standard breast milk. This feeding strategy is safe and effective for very low birth weight infants.
Area of Science:
- Neonatal nutrition
- Pediatric gastroenterology
- Premature infant care
Context:
- Very premature infants (1,010-1,500 g) require specialized nutritional support.
- Standard pooled breast milk may not meet the high energy and protein demands of these infants.
- Optimizing nutrition is crucial for improving outcomes in extremely low birth weight neonates.
Purpose:
- To evaluate the efficacy and safety of concentrated breast milk for feeding very premature infants.
- To compare growth parameters and clinical outcomes between infants fed concentrated and standard breast milk.
- To assess the impact of concentrated breast milk on mortality and morbidities like necrotizing enterocolitis.
Summary:
- A prospective study used concentrated breast milk (103 cal/100 ml) via nasogastric feeding in 26 very premature infants (1,010-1,500 g).
- Compared to 57 controls receiving standard breast milk, the concentrated group achieved full oral caloric supply earlier.
- The concentrated formula provided higher protein and sodium but less fat per kilogram than standard milk.
- Mortality was lower (15% vs. 28%) and necrotizing enterocolitis rates were similar (3.3% vs. 3.5%) in the concentrated group.
- Postnatal weight gain and linear growth were comparable, with slightly higher plasma sodium and urea observed in the concentrated group during the second week.
Impact:
- Concentrated breast milk can be a viable option for optimizing nutrition in very premature infants.
- This approach may contribute to improved survival rates and comparable growth in this vulnerable population.
- Further research could explore long-term neurodevelopmental outcomes and optimal nutrient profiles.
Abstract:
The use of concentrated breast milk was prospectively studied in 26 very small premature babies with a birth weight of 1,010-1,500 g. 57 premature babies of the same birth weight group born in the two preceding years and fed normal pooled breast milk served as a control group. Fresh breast milk was enriched using lyophilized breast milk yielding a calory content of 103 cal/100 ml. Early intermittent nasogastric feeding using this milk enabled full oral calory supply from the 5th day on. 130 ml/kg/day of enriched breast milk yields 134 cal/kg per day with somewhat less fat but more protein (2.8 g/kg vs 2.2 g/kg) and sodium (1.9 mmol vs 1.5 mmol) than 200 ml/kg/day of ordinary breast milk. About 50% of the study patients and the control group needed intensive care with mechanical ventilation. Mortality was 15% and 28%, respectively. Necrotizing enterocolitis was rare in both groups (3.3 vs 3.5%). Due to extragastric complications oral feeding had to be reduced in 18% (study group) and in 27% (ordinary breast milk), the most frequent indication was a patent ductus arteriosus with heart insufficiency. Postnatal weight gain was comparatively good with a mean increment of 112 g in the second and 150 g in the third week. Growth of body length during the first three weeks was on average 0.72 cm/week, head circumference increased 0.57 cm/week. However, in the control group similar results were noted. During the second week of life patients fed concentrated breast milk had somewhat higher plasma sodium und urea values.(ABSTRACT TRUNCATED AT 250 WORDS)