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Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants.
J Pediatr. 2013 Dec; 163(6):1592-1595.e1.JPed

Abstract

OBJECTIVE

To compare the duration of parenteral nutrition, growth, and morbidity in extremely premature infants fed exclusive diets of either bovine milk-based preterm formula (BOV) or donor human milk and human milk-based human milk fortifier (HUM), in a randomized trial of formula vs human milk.

STUDY DESIGN

Multicenter randomized controlled trial. The authors studied extremely preterm infants whose mothers did not provide their milk. Infants were fed either BOV or an exclusive human milk diet of pasteurized donor human milk and HUM. The major outcome was duration of parenteral nutrition. Secondary outcomes were growth, respiratory support, and necrotizing enterocolitis (NEC).

RESULTS

Birth weight (983 vs 996 g) and gestational age (27.5 vs 27.7 wk), in BOV and HUM, respectively, were similar. There was a significant difference in median parenteral nutrition days: 36 vs 27, in BOV vs HUM, respectively (P = .04). The incidence of NEC in BOV was 21% (5 cases) vs 3% in HUM (1 case), P = .08; surgical NEC was significantly higher in BOV (4 cases) than HUM (0 cases), P = .04.

CONCLUSIONS

In extremely preterm infants given exclusive diets of preterm formula vs human milk, there was a significantly greater duration of parenteral nutrition and higher rate of surgical NEC in infants receiving preterm formula. This trial supports the use of an exclusive human milk diet to nourish extremely preterm infants in the neonatal intensive care unit.

Authors+Show Affiliations

Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23968744

Citation

Cristofalo, Elizabeth A., et al. "Randomized Trial of Exclusive Human Milk Versus Preterm Formula Diets in Extremely Premature Infants." The Journal of Pediatrics, vol. 163, no. 6, 2013, pp. 1592-1595.e1.
Cristofalo EA, Schanler RJ, Blanco CL, et al. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. J Pediatr. 2013;163(6):1592-1595.e1.
Cristofalo, E. A., Schanler, R. J., Blanco, C. L., Sullivan, S., Trawoeger, R., Kiechl-Kohlendorfer, U., Dudell, G., Rechtman, D. J., Lee, M. L., Lucas, A., & Abrams, S. (2013). Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. The Journal of Pediatrics, 163(6), 1592-e1. https://doi.org/10.1016/j.jpeds.2013.07.011
Cristofalo EA, et al. Randomized Trial of Exclusive Human Milk Versus Preterm Formula Diets in Extremely Premature Infants. J Pediatr. 2013;163(6):1592-1595.e1. PubMed PMID: 23968744.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. AU - Cristofalo,Elizabeth A, AU - Schanler,Richard J, AU - Blanco,Cynthia L, AU - Sullivan,Sandra, AU - Trawoeger,Rudolf, AU - Kiechl-Kohlendorfer,Ursula, AU - Dudell,Golde, AU - Rechtman,David J, AU - Lee,Martin L, AU - Lucas,Alan, AU - Abrams,Steven, Y1 - 2013/08/20/ PY - 2013/02/15/received PY - 2013/06/19/revised PY - 2013/07/03/accepted PY - 2013/8/24/entrez PY - 2013/8/24/pubmed PY - 2014/1/28/medline KW - BOV KW - Bovine milk–based preterm formula KW - HUM KW - Human milk fortifier KW - NEC KW - Necrotizing enterocolitis SP - 1592 EP - 1595.e1 JF - The Journal of pediatrics JO - J. Pediatr. VL - 163 IS - 6 N2 - OBJECTIVE: To compare the duration of parenteral nutrition, growth, and morbidity in extremely premature infants fed exclusive diets of either bovine milk-based preterm formula (BOV) or donor human milk and human milk-based human milk fortifier (HUM), in a randomized trial of formula vs human milk. STUDY DESIGN: Multicenter randomized controlled trial. The authors studied extremely preterm infants whose mothers did not provide their milk. Infants were fed either BOV or an exclusive human milk diet of pasteurized donor human milk and HUM. The major outcome was duration of parenteral nutrition. Secondary outcomes were growth, respiratory support, and necrotizing enterocolitis (NEC). RESULTS: Birth weight (983 vs 996 g) and gestational age (27.5 vs 27.7 wk), in BOV and HUM, respectively, were similar. There was a significant difference in median parenteral nutrition days: 36 vs 27, in BOV vs HUM, respectively (P = .04). The incidence of NEC in BOV was 21% (5 cases) vs 3% in HUM (1 case), P = .08; surgical NEC was significantly higher in BOV (4 cases) than HUM (0 cases), P = .04. CONCLUSIONS: In extremely preterm infants given exclusive diets of preterm formula vs human milk, there was a significantly greater duration of parenteral nutrition and higher rate of surgical NEC in infants receiving preterm formula. This trial supports the use of an exclusive human milk diet to nourish extremely preterm infants in the neonatal intensive care unit. SN - 1097-6833 UR - https://www.unboundmedicine.com/medline/citation/23968744/Randomized_trial_of_exclusive_human_milk_versus_preterm_formula_diets_in_extremely_premature_infants_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(13)00865-2 DB - PRIME DP - Unbound Medicine ER -