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Optimizing the Use of Human Milk Cream Supplement in Very Preterm Infants: Growth and Cost Outcomes.
Nutr Clin Pract. 2020 Aug; 35(4):689-696.NC

Abstract

BACKGROUND

An exclusive human milk-based diet has been shown to decrease necrotizing enterocolitis and improve outcomes for infants ≤1250 g birth weight. Studies have shown that infants who received an exclusive human milk diet with a donor-human milk-derived cream supplement (cream) had improved weight and length velocity when the cream was added to mother's own milk or donor-human milk when energy was <20 kcal/oz using a human milk analyzer. Our objective was to compare growth and cost outcomes of infants ≤1250 g birth weight fed with an exclusive human milk diet, with and without human milk cream, without the use of a human milk analyzer.

METHODS

Two cohorts of human milk-fed premature infants were compared from birth to 34 weeks postmenstrual age. Group 1 (2010-2011) received a donor-human milk fortifier, whereas Group 2 (2015-2016) received donor-human milk fortifier plus the commercial cream supplement, if weight gain was <15 g/kg/d.

RESULTS

There was no difference in growth between the 2 groups for weight (P = 0.32) or head circumference (P = 0.90). Length velocity was greater for Group 1 (P = 0.03). The mean dose of donor-human milk fortifier was lower in Group 2 (P < 0.001). Group 2 saved an average of $2318 per patient on the cost of human milk products (P < 0.01).

CONCLUSIONS

Infants receiving a human milk diet with cream supplementation for growth faltering achieve appropriate growth in a cost-effective feeding strategy.

Authors+Show Affiliations

Department of Pediatrics, Section of Neonatology, Vanderbilt University, Nashville, Tennessee, USA. Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.Clinical Nutrition Services, Texas Children's Hospital, Houston, Texas, USA.Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.Department of Pediatrics, Division of Neonatology, University of South Florida College of Medicine, Tampa, Florida, USA.Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31642112

Citation

Knake, Lindsey A., et al. "Optimizing the Use of Human Milk Cream Supplement in Very Preterm Infants: Growth and Cost Outcomes." Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 35, no. 4, 2020, pp. 689-696.
Knake LA, King BC, Gollins LA, et al. Optimizing the Use of Human Milk Cream Supplement in Very Preterm Infants: Growth and Cost Outcomes. Nutr Clin Pract. 2020;35(4):689-696.
Knake, L. A., King, B. C., Gollins, L. A., Hurst, N. M., Hagan, J., Ford, S. L., & Hair, A. B. (2020). Optimizing the Use of Human Milk Cream Supplement in Very Preterm Infants: Growth and Cost Outcomes. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 35(4), 689-696. https://doi.org/10.1002/ncp.10423
Knake LA, et al. Optimizing the Use of Human Milk Cream Supplement in Very Preterm Infants: Growth and Cost Outcomes. Nutr Clin Pract. 2020;35(4):689-696. PubMed PMID: 31642112.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optimizing the Use of Human Milk Cream Supplement in Very Preterm Infants: Growth and Cost Outcomes. AU - Knake,Lindsey A, AU - King,Brian C, AU - Gollins,Laura A, AU - Hurst,Nancy M, AU - Hagan,Joseph, AU - Ford,Steven L, AU - Hair,Amy B, Y1 - 2019/10/22/ PY - 2019/10/24/pubmed PY - 2019/10/24/medline PY - 2019/10/24/entrez KW - cream KW - enteral nutrition KW - human milk KW - human milk fortifier KW - human milk supplement KW - neonates SP - 689 EP - 696 JF - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JO - Nutr Clin Pract VL - 35 IS - 4 N2 - BACKGROUND: An exclusive human milk-based diet has been shown to decrease necrotizing enterocolitis and improve outcomes for infants ≤1250 g birth weight. Studies have shown that infants who received an exclusive human milk diet with a donor-human milk-derived cream supplement (cream) had improved weight and length velocity when the cream was added to mother's own milk or donor-human milk when energy was <20 kcal/oz using a human milk analyzer. Our objective was to compare growth and cost outcomes of infants ≤1250 g birth weight fed with an exclusive human milk diet, with and without human milk cream, without the use of a human milk analyzer. METHODS: Two cohorts of human milk-fed premature infants were compared from birth to 34 weeks postmenstrual age. Group 1 (2010-2011) received a donor-human milk fortifier, whereas Group 2 (2015-2016) received donor-human milk fortifier plus the commercial cream supplement, if weight gain was <15 g/kg/d. RESULTS: There was no difference in growth between the 2 groups for weight (P = 0.32) or head circumference (P = 0.90). Length velocity was greater for Group 1 (P = 0.03). The mean dose of donor-human milk fortifier was lower in Group 2 (P < 0.001). Group 2 saved an average of $2318 per patient on the cost of human milk products (P < 0.01). CONCLUSIONS: Infants receiving a human milk diet with cream supplementation for growth faltering achieve appropriate growth in a cost-effective feeding strategy. SN - 1941-2452 UR - https://www.unboundmedicine.com/medline/citation/31642112/Optimizing_the_Use_of_Human_Milk_Cream_Supplement_in_Very_Preterm_Infants:_Growth_and_Cost_Outcomes L2 - https://doi.org/10.1002/ncp.10423 DB - PRIME DP - Unbound Medicine ER -
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