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Neurodevelopmental Outcome of Extremely Low Birth Weight Infants Fed an Exclusive Human Milk Diet Is Not Affected by Growth Velocity.
Breastfeed Med. 2020 Jun; 15(6):362-369.BM

Abstract

Background:

An exclusive human milk (EHM) diet in extremely low birth weight (ELBW) infants (birth weight ≤1,000 g) is linked to an increased likelihood of extrauterine growth restriction (EUGR, weight <10% at discharge). Past studies associated EUGR with worse neurodevelopmental (ND) outcomes; however, its impact when an EHM diet is used is unknown.

Objective:

Determine whether EUGR adversely affects 2-year ND outcomes of ELBW infants fed an EHM diet. Secondary aims were to compare short-term morbidities and growth through 2 years corrected age (CA). Materials and

Methods:

Prospective cohort study of ELBW infants fed an EHM diet until 34 weeks corrected gestational age and assessed at 2 years CA. ND outcomes between EUGR and non-EUGR infants were compared using the Bayley Scales of Infant Development 3rd Ed (BSID-III).

Results:

Eighty-one ELBW infants survived, 44 were seen for follow-up, and 16 (36%) were EUGR. Baseline characteristics and Neonatal Intensive Care Unit (NICU) morbidities were similar. There were no statistically significant differences (median [25-75%]) between EUGR and non-EUGR groups in cognition, (90 [80-99] versus 95 [90-104]), language (84 [68-105] versus 89 [75-100]), or motor composite scores (87 [74-96] versus 91 [88-96]). Weight z-scores during NICU stay dropped in both groups, more pronounced for the EUGR infants. There was no difference in linear or head growth.

Conclusion:

In our institution, ND outcomes at 2 years CA for ELBW infants fed an EHM diet were similar regardless of EUGR status. This suggests a neuroprotective effect of EHM diet in the ELBW population, despite weight gain velocity during NICU stay.

Authors+Show Affiliations

Division of Neonatology, Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, New York, USA. Westchester Medical Center, Division of Newborn Medicine, Maria Fareri Children's Hospital, Valhalla, New York, USA.Westchester Medical Center, Division of Newborn Medicine, Maria Fareri Children's Hospital, Valhalla, New York, USA.Westchester Medical Center, Division of Newborn Medicine, Maria Fareri Children's Hospital, Valhalla, New York, USA. Department of Pediatrics, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.Westchester Medical Center, Division of Newborn Medicine, Maria Fareri Children's Hospital, Valhalla, New York, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32311293

Citation

Rahman, Amanda, et al. "Neurodevelopmental Outcome of Extremely Low Birth Weight Infants Fed an Exclusive Human Milk Diet Is Not Affected By Growth Velocity." Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine, vol. 15, no. 6, 2020, pp. 362-369.
Rahman A, Kase JS, Murray YL, et al. Neurodevelopmental Outcome of Extremely Low Birth Weight Infants Fed an Exclusive Human Milk Diet Is Not Affected by Growth Velocity. Breastfeed Med. 2020;15(6):362-369.
Rahman, A., Kase, J. S., Murray, Y. L., & Parvez, B. (2020). Neurodevelopmental Outcome of Extremely Low Birth Weight Infants Fed an Exclusive Human Milk Diet Is Not Affected by Growth Velocity. Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine, 15(6), 362-369. https://doi.org/10.1089/bfm.2019.0214
Rahman A, et al. Neurodevelopmental Outcome of Extremely Low Birth Weight Infants Fed an Exclusive Human Milk Diet Is Not Affected By Growth Velocity. Breastfeed Med. 2020;15(6):362-369. PubMed PMID: 32311293.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurodevelopmental Outcome of Extremely Low Birth Weight Infants Fed an Exclusive Human Milk Diet Is Not Affected by Growth Velocity. AU - Rahman,Amanda, AU - Kase,Jordan S, AU - Murray,Yuanyi L, AU - Parvez,Boriana, Y1 - 2020/04/20/ PY - 2020/4/21/pubmed PY - 2020/4/21/medline PY - 2020/4/21/entrez KW - ELBW infant KW - breastfeeding KW - human milk diet KW - neurodevelopment SP - 362 EP - 369 JF - Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine JO - Breastfeed Med VL - 15 IS - 6 N2 - Background: An exclusive human milk (EHM) diet in extremely low birth weight (ELBW) infants (birth weight ≤1,000 g) is linked to an increased likelihood of extrauterine growth restriction (EUGR, weight <10% at discharge). Past studies associated EUGR with worse neurodevelopmental (ND) outcomes; however, its impact when an EHM diet is used is unknown. Objective: Determine whether EUGR adversely affects 2-year ND outcomes of ELBW infants fed an EHM diet. Secondary aims were to compare short-term morbidities and growth through 2 years corrected age (CA). Materials and Methods: Prospective cohort study of ELBW infants fed an EHM diet until 34 weeks corrected gestational age and assessed at 2 years CA. ND outcomes between EUGR and non-EUGR infants were compared using the Bayley Scales of Infant Development 3rd Ed (BSID-III). Results: Eighty-one ELBW infants survived, 44 were seen for follow-up, and 16 (36%) were EUGR. Baseline characteristics and Neonatal Intensive Care Unit (NICU) morbidities were similar. There were no statistically significant differences (median [25-75%]) between EUGR and non-EUGR groups in cognition, (90 [80-99] versus 95 [90-104]), language (84 [68-105] versus 89 [75-100]), or motor composite scores (87 [74-96] versus 91 [88-96]). Weight z-scores during NICU stay dropped in both groups, more pronounced for the EUGR infants. There was no difference in linear or head growth. Conclusion: In our institution, ND outcomes at 2 years CA for ELBW infants fed an EHM diet were similar regardless of EUGR status. This suggests a neuroprotective effect of EHM diet in the ELBW population, despite weight gain velocity during NICU stay. SN - 1556-8342 UR - https://www.unboundmedicine.com/medline/citation/32311293/Neurodevelopmental_Outcome_of_Extremely_Low_Birth_Weight_Infants_Fed_an_Exclusive_Human_Milk_Diet_Is_Not_Affected_by_Growth_Velocity_ L2 - https://www.liebertpub.com/doi/10.1089/bfm.2019.0214?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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