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Effects of Donor Breastmilk Feeding on Growth and Early Neurodevelopmental Outcomes in Preterm Infants: An Observational Study.
Clin Ther. 2017 Jun; 39(6):1210-1220.CT

Abstract

PURPOSE

Donor breastmilk (DBM) has gained popularity as an alternative to formula when mother's own milk (MOM) is unavailable. The objective of this study was to evaluate the effects of a predominantly DBM diet on growth and subsequent neurodevelopment in preterm infants at a level 3 neonatal intensive care unit (NICU).

METHODS

This single-center, observational cohort study compared data from preterm infants supplemented with predominantly (>50%) DBM to those from age- and weight-matched infants fed only MOM or supplemented with predominantly (>50%) preterm formula (PF). The primary outcome was in-hospital weight gain, and the secondary outcome was neurodevelopment, as assessed by the Bayley III scale at 1 and 2 years' corrected age. Exclusion criteria were major congenital defects, death prior to discharge from the NICU, or supplementation volumes of <50% over the first month of life. We compared the outcomes among the 3 feeding groups with the χ2 test, ANOVA, and ANCOVA, with post hoc pairwise comparisons after adjustment for the following confounders: bronchopulmonary dysplasia, multiple births, and social work involvement.

FINDINGS

In the entire cohort, the mean gestational age was 27.1 weeks and the mean birthweight was 914 g. The DBM (n = 27) and PF (n = 25) groups were similar with regard to socioeconomic characteristics. DBM infants regained birthweight more slowly over the first month of life compared with infants fed MOM (n = 29) or PF (mean [SD], 17.9 [5.7], 22.0 [6.8], and 20.3 [5.7] g/kg/d, respectively; P = 0.05); however, this growth difference was attenuated at later time points. In a fully adjusted model, the DBM group scored significantly lower in cognition at both 1 year (P = 0.005) and 2 years (P = 0.03) of age compared with the infants fed non-DBM diets.

IMPLICATIONS

The findings from this study suggest that in this NICU, preterm infants supplemented with predominantly DBM had compromised early in-hospital weight gain and, possibly, early cognitive delays compared with infants fed only MOM or infants supplemented with predominantly PF. These findings reinforce the need for further research on the optimal use of DBM in the preterm population and a continued need for promoting breastfeeding efforts to supply MOM.

Authors+Show Affiliations

Department of Pediatric Newborn Medicine, Tufts Medical Center, Boston, Massachusetts; Department of Pediatric Newborn Medicine, Baystate Medical Center, Springfield, Massachusetts. Electronic address: Laura.MadoreMD@baystatehealth.org.Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts.Department of Pediatric Newborn Medicine, Tufts Medical Center, Boston, Massachusetts; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts.Department of Pediatric Newborn Medicine, Tufts Medical Center, Boston, Massachusetts.Department of Pediatric Newborn Medicine, Tufts Medical Center, Boston, Massachusetts.Department of Pediatric Newborn Medicine, Tufts Medical Center, Boston, Massachusetts; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28576299

Citation

Madore, Laura S., et al. "Effects of Donor Breastmilk Feeding On Growth and Early Neurodevelopmental Outcomes in Preterm Infants: an Observational Study." Clinical Therapeutics, vol. 39, no. 6, 2017, pp. 1210-1220.
Madore LS, Bora S, Erdei C, et al. Effects of Donor Breastmilk Feeding on Growth and Early Neurodevelopmental Outcomes in Preterm Infants: An Observational Study. Clin Ther. 2017;39(6):1210-1220.
Madore, L. S., Bora, S., Erdei, C., Jumani, T., Dengos, A. R., & Sen, S. (2017). Effects of Donor Breastmilk Feeding on Growth and Early Neurodevelopmental Outcomes in Preterm Infants: An Observational Study. Clinical Therapeutics, 39(6), 1210-1220. https://doi.org/10.1016/j.clinthera.2017.05.341
Madore LS, et al. Effects of Donor Breastmilk Feeding On Growth and Early Neurodevelopmental Outcomes in Preterm Infants: an Observational Study. Clin Ther. 2017;39(6):1210-1220. PubMed PMID: 28576299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of Donor Breastmilk Feeding on Growth and Early Neurodevelopmental Outcomes in Preterm Infants: An Observational Study. AU - Madore,Laura S, AU - Bora,Samudragupta, AU - Erdei,Carmina, AU - Jumani,Tina, AU - Dengos,Allison R, AU - Sen,Sarbattama, Y1 - 2017/05/30/ PY - 2017/03/20/received PY - 2017/05/05/revised PY - 2017/05/09/accepted PY - 2017/6/4/pubmed PY - 2017/12/1/medline PY - 2017/6/4/entrez KW - donor breastmilk KW - growth KW - neurodevelopment KW - preterm infants SP - 1210 EP - 1220 JF - Clinical therapeutics JO - Clin Ther VL - 39 IS - 6 N2 - PURPOSE: Donor breastmilk (DBM) has gained popularity as an alternative to formula when mother's own milk (MOM) is unavailable. The objective of this study was to evaluate the effects of a predominantly DBM diet on growth and subsequent neurodevelopment in preterm infants at a level 3 neonatal intensive care unit (NICU). METHODS: This single-center, observational cohort study compared data from preterm infants supplemented with predominantly (>50%) DBM to those from age- and weight-matched infants fed only MOM or supplemented with predominantly (>50%) preterm formula (PF). The primary outcome was in-hospital weight gain, and the secondary outcome was neurodevelopment, as assessed by the Bayley III scale at 1 and 2 years' corrected age. Exclusion criteria were major congenital defects, death prior to discharge from the NICU, or supplementation volumes of <50% over the first month of life. We compared the outcomes among the 3 feeding groups with the χ2 test, ANOVA, and ANCOVA, with post hoc pairwise comparisons after adjustment for the following confounders: bronchopulmonary dysplasia, multiple births, and social work involvement. FINDINGS: In the entire cohort, the mean gestational age was 27.1 weeks and the mean birthweight was 914 g. The DBM (n = 27) and PF (n = 25) groups were similar with regard to socioeconomic characteristics. DBM infants regained birthweight more slowly over the first month of life compared with infants fed MOM (n = 29) or PF (mean [SD], 17.9 [5.7], 22.0 [6.8], and 20.3 [5.7] g/kg/d, respectively; P = 0.05); however, this growth difference was attenuated at later time points. In a fully adjusted model, the DBM group scored significantly lower in cognition at both 1 year (P = 0.005) and 2 years (P = 0.03) of age compared with the infants fed non-DBM diets. IMPLICATIONS: The findings from this study suggest that in this NICU, preterm infants supplemented with predominantly DBM had compromised early in-hospital weight gain and, possibly, early cognitive delays compared with infants fed only MOM or infants supplemented with predominantly PF. These findings reinforce the need for further research on the optimal use of DBM in the preterm population and a continued need for promoting breastfeeding efforts to supply MOM. SN - 1879-114X UR - https://www.unboundmedicine.com/medline/citation/28576299/Effects_of_Donor_Breastmilk_Feeding_on_Growth_and_Early_Neurodevelopmental_Outcomes_in_Preterm_Infants:_An_Observational_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0149-2918(17)30639-2 DB - PRIME DP - Unbound Medicine ER -