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Beyond Necrotizing Enterocolitis Prevention: Improving Outcomes with an Exclusive Human Milk-Based Diet.
Breastfeed Med. 2016 Mar; 11(2):70-4.BM

Abstract

OBJECTIVE

The aim of this study was to compare outcomes of infants pre and post initiation of a feeding protocol providing an exclusive human milk-based diet (HUM).

MATERIALS AND METHODS

In a multicenter retrospective cohort study, infants with a birth weight <1,250 g who received a bovine-based diet (BOV) of mother's own milk fortified with bovine fortifier and/or preterm formula were compared to infants who received a newly introduced HUM feeding protocol. Infants were excluded if they had major congenital anomalies or died in the first 12 hours of life. Data were collected 2-3 years prior to and after introduction of an exclusive HUM diet. Primary outcomes were necrotizing enterocolitis (NEC) and mortality. Secondary outcomes included late-onset sepsis, retinopathy of prematurity (ROP), and bronchopulmonary dysplasia (BPD).

RESULTS

A total of 1,587 infants were included from four centers in Texas, Illinois, Florida, and California. There were no differences in baseline demographics or growth of infants. The HUM group had significantly lower incidence of proven NEC (16.7% versus 6.9%, p < 0.00001), mortality (17.2% versus 13.6%, p = 0.04), late-onset sepsis (30.3% versus 19.0%, p < 0.00001), ROP (9% versus 5.2%, p = 0.003), and BPD (56.3% versus 47.7%, p = 0.0015) compared with the BOV group.

CONCLUSIONS

Extremely premature infants who received an exclusive HUM diet had a significantly lower incidence of NEC and mortality. The HUM group also had a reduction in late-onset sepsis, BPD, and ROP. This multicenter study further emphasizes the many benefits of an exclusive HUM diet, and demonstrates multiple improved outcomes after implementation of such a feeding protocol.

Authors+Show Affiliations

1 USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital , Houston, Texas.1 USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital , Houston, Texas.1 USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital , Houston, Texas.2 Department of Neonatology, Winnie Palmer Hospital for Women and Babies , Orlando, Florida.2 Department of Neonatology, Winnie Palmer Hospital for Women and Babies , Orlando, Florida.3 Department of Pediatrics, Northwestern University Feinberg School of Medicine , Chicago, Illinois.4 Department of Clinical Nutrition Services, Northwestern Memorial Hospital , Chicago, Illinois.5 Department of Neonatology, Good Samaritan Hospital , San Jose, California.6 Prolacta Bioscience , Industry, California.1 USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital , Houston, Texas.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

26789484

Citation

Hair, Amy B., et al. "Beyond Necrotizing Enterocolitis Prevention: Improving Outcomes With an Exclusive Human Milk-Based Diet." Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine, vol. 11, no. 2, 2016, pp. 70-4.
Hair AB, Peluso AM, Hawthorne KM, et al. Beyond Necrotizing Enterocolitis Prevention: Improving Outcomes with an Exclusive Human Milk-Based Diet. Breastfeed Med. 2016;11(2):70-4.
Hair, A. B., Peluso, A. M., Hawthorne, K. M., Perez, J., Smith, D. P., Khan, J. Y., O'Donnell, A., Powers, R. J., Lee, M. L., & Abrams, S. A. (2016). Beyond Necrotizing Enterocolitis Prevention: Improving Outcomes with an Exclusive Human Milk-Based Diet. Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine, 11(2), 70-4. https://doi.org/10.1089/bfm.2015.0134
Hair AB, et al. Beyond Necrotizing Enterocolitis Prevention: Improving Outcomes With an Exclusive Human Milk-Based Diet. Breastfeed Med. 2016;11(2):70-4. PubMed PMID: 26789484.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Beyond Necrotizing Enterocolitis Prevention: Improving Outcomes with an Exclusive Human Milk-Based Diet. AU - Hair,Amy B, AU - Peluso,Allison M, AU - Hawthorne,Keli M, AU - Perez,Jose, AU - Smith,Denise P, AU - Khan,Janine Y, AU - O'Donnell,Andrea, AU - Powers,Richard J, AU - Lee,Martin L, AU - Abrams,Steven A, Y1 - 2016/01/20/ PY - 2016/1/21/entrez PY - 2016/1/21/pubmed PY - 2016/12/29/medline SP - 70 EP - 4 JF - Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine JO - Breastfeed Med VL - 11 IS - 2 N2 - OBJECTIVE: The aim of this study was to compare outcomes of infants pre and post initiation of a feeding protocol providing an exclusive human milk-based diet (HUM). MATERIALS AND METHODS: In a multicenter retrospective cohort study, infants with a birth weight <1,250 g who received a bovine-based diet (BOV) of mother's own milk fortified with bovine fortifier and/or preterm formula were compared to infants who received a newly introduced HUM feeding protocol. Infants were excluded if they had major congenital anomalies or died in the first 12 hours of life. Data were collected 2-3 years prior to and after introduction of an exclusive HUM diet. Primary outcomes were necrotizing enterocolitis (NEC) and mortality. Secondary outcomes included late-onset sepsis, retinopathy of prematurity (ROP), and bronchopulmonary dysplasia (BPD). RESULTS: A total of 1,587 infants were included from four centers in Texas, Illinois, Florida, and California. There were no differences in baseline demographics or growth of infants. The HUM group had significantly lower incidence of proven NEC (16.7% versus 6.9%, p < 0.00001), mortality (17.2% versus 13.6%, p = 0.04), late-onset sepsis (30.3% versus 19.0%, p < 0.00001), ROP (9% versus 5.2%, p = 0.003), and BPD (56.3% versus 47.7%, p = 0.0015) compared with the BOV group. CONCLUSIONS: Extremely premature infants who received an exclusive HUM diet had a significantly lower incidence of NEC and mortality. The HUM group also had a reduction in late-onset sepsis, BPD, and ROP. This multicenter study further emphasizes the many benefits of an exclusive HUM diet, and demonstrates multiple improved outcomes after implementation of such a feeding protocol. SN - 1556-8342 UR - https://www.unboundmedicine.com/medline/citation/26789484/Beyond_Necrotizing_Enterocolitis_Prevention:_Improving_Outcomes_with_an_Exclusive_Human_Milk_Based_Diet_ L2 - https://www.liebertpub.com/doi/full/10.1089/bfm.2015.0134?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -