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Proportionate Postnatal Growth in Preterm Neonates on Expressed Breast Milk Feeding With Selected Fortification.
Nutr Clin Pract. 2020 Aug; 35(4):715-723.NC

Abstract

BACKGROUND

Preterm neonates not fed an exclusive human-milk diet in the neonatal intensive care unit (NICU) show disproportionate postnatal growth. There are scant data on postnatal growth in neonates from India fed an exclusive expressed breast milk (EBM) diet. This study describes the postnatal changes in weight, length, and head circumference in preterm neonates given EBM with selected fortification.

METHODS

The study had a prospective observational design. Exclusive EBM feeding, early initiation, and standardized progression of feeds was followed. Fortification of breast milk with human milk fortifier (HMF) or liquid calcium phosphate and multivitamins (CALVIT) or hindmilk (HM) was done based on the gestational age. Monitoring for weight, length, and head circumference was done from admission to discharge.

RESULTS

Ninety-three preterm neonates were included in the study, of which 34 (36.6%) were small for gestational age. Thirty-two (34.3%) neonates received EBM with HMF, 35 (35.7%) received EBM fortified with CALVIT and 26 (28%) neonates received HM fortification. There was a significant difference in the change in z-scores from birth to discharge for the weight, length, and head circumference (P = .001). The mean increase in daily weight ranged from 8.8 to 9.5 g/d, whereas weekly change in length was 0.8-0.9 cm/wk, and head circumference was 0.7 cm/wk.

CONCLUSION

Postnatal growth of preterm neonates during NICU admission on exclusive EBM feeding with selected fortification resulted in a proportionate increase in weight, length, and head circumference.

Authors+Show Affiliations

Army Hospital (Referral and Research), New Delhi, India.Army Hospital (Referral and Research), New Delhi, India.Army Hospital (Referral and Research), New Delhi, India.Army Hospital (Referral and Research), New Delhi, India.Army Hospital (Referral and Research), New Delhi, India.Army Hospital (Referral and Research), New Delhi, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32383218

Citation

Tewari, Vishal Vishnu, et al. "Proportionate Postnatal Growth in Preterm Neonates On Expressed Breast Milk Feeding With Selected Fortification." Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 35, no. 4, 2020, pp. 715-723.
Tewari VV, Kumar A, Singhal A, et al. Proportionate Postnatal Growth in Preterm Neonates on Expressed Breast Milk Feeding With Selected Fortification. Nutr Clin Pract. 2020;35(4):715-723.
Tewari, V. V., Kumar, A., Singhal, A., Prakash, A., Pillai, N., & Varghese, J. (2020). Proportionate Postnatal Growth in Preterm Neonates on Expressed Breast Milk Feeding With Selected Fortification. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 35(4), 715-723. https://doi.org/10.1002/ncp.10494
Tewari VV, et al. Proportionate Postnatal Growth in Preterm Neonates On Expressed Breast Milk Feeding With Selected Fortification. Nutr Clin Pract. 2020;35(4):715-723. PubMed PMID: 32383218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Proportionate Postnatal Growth in Preterm Neonates on Expressed Breast Milk Feeding With Selected Fortification. AU - Tewari,Vishal Vishnu, AU - Kumar,Ashutosh, AU - Singhal,Amit, AU - Prakash,Arya, AU - Pillai,Nayana, AU - Varghese,Jaya, Y1 - 2020/05/07/ PY - 2020/5/10/pubmed PY - 2020/5/10/medline PY - 2020/5/9/entrez KW - fortification KW - growth KW - head circumference KW - human milk KW - length KW - neonatal intensive care KW - premature infant KW - weight SP - 715 EP - 723 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: Preterm neonates not fed an exclusive human-milk diet in the neonatal intensive care unit (NICU) show disproportionate postnatal growth. There are scant data on postnatal growth in neonates from India fed an exclusive expressed breast milk (EBM) diet. This study describes the postnatal changes in weight, length, and head circumference in preterm neonates given EBM with selected fortification. METHODS: The study had a prospective observational design. Exclusive EBM feeding, early initiation, and standardized progression of feeds was followed. Fortification of breast milk with human milk fortifier (HMF) or liquid calcium phosphate and multivitamins (CALVIT) or hindmilk (HM) was done based on the gestational age. Monitoring for weight, length, and head circumference was done from admission to discharge. RESULTS: Ninety-three preterm neonates were included in the study, of which 34 (36.6%) were small for gestational age. Thirty-two (34.3%) neonates received EBM with HMF, 35 (35.7%) received EBM fortified with CALVIT and 26 (28%) neonates received HM fortification. There was a significant difference in the change in z-scores from birth to discharge for the weight, length, and head circumference (P = .001). The mean increase in daily weight ranged from 8.8 to 9.5 g/d, whereas weekly change in length was 0.8-0.9 cm/wk, and head circumference was 0.7 cm/wk. CONCLUSION: Postnatal growth of preterm neonates during NICU admission on exclusive EBM feeding with selected fortification resulted in a proportionate increase in weight, length, and head circumference. SN - 1941-2452 UR - https://www.unboundmedicine.com/medline/citation/32383218/Proportionate_Postnatal_Growth_in_Preterm_Neonates_on_Expressed_Breast_Milk_Feeding_With_Selected_Fortification L2 - https://doi.org/10.1002/ncp.10494 DB - PRIME DP - Unbound Medicine ER -
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