scholarly journals Low Iodine Content in the Diets of Hospitalized Preterm Infants

2012 ◽  
Vol 97 (4) ◽  
pp. E632-E636 ◽  
Author(s):  
Mandy B. Belfort ◽  
Elizabeth N. Pearce ◽  
Lewis E. Braverman ◽  
Xuemei He ◽  
Rosalind S. Brown
Keyword(s):  
Parenteral Nutrition ◽  
Human Milk ◽  
Preterm Infants ◽  
Iodine Content ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Hormone Synthesis ◽  
Donor Human Milk ◽  
Preterm Formula ◽  
Enteral And Parenteral Nutrition

Context: Iodine is critical for normal thyroid hormone synthesis and brain development during infancy, and preterm infants are particularly vulnerable to the effects of both iodine deficiency and excess. Use of iodine-containing skin antiseptics in intensive care nurseries has declined substantially in recent years, but whether the current dietary iodine intake meets the requirement for hospitalized preterm infants is unknown. Objective: The aim of the study was to measure the iodine content of enteral and parenteral nutrition products commonly used for hospitalized preterm infants and estimate the daily iodine intake for a hypothetical 1-kg infant. Methods: We used mass spectrometry to measure the iodine concentration of seven preterm infant formulas, 10 samples of pooled donor human milk, two human milk fortifiers (HMF) and other enteral supplements, and a parenteral amino acid solution and soy-based lipid emulsion. We calculated the iodine provided by typical diets based on 150 ml/kg · d of formula, donor human milk with or without HMF, and parenteral nutrition. Results: Preterm formula provided 16.4–28.5 μg/d of iodine, whereas unfortified donor human milk provided only 5.0–17.6 μg/d. Adding two servings (six packets) of Similac HMF to human milk increased iodine intake by 11.7 μg/d, whereas adding two servings of Enfamil HMF increased iodine intake by only 0.9 μg/d. The other enteral supplements contained almost no iodine, nor did a parenteral nutrition-based diet. Conclusions: Typical enteral diets for hospitalized preterm infants, particularly those based on donor human milk, provide less than the recommended 30 μg/d of iodine, and parenteral nutrition provides almost no iodine. Additional iodine fortification should be considered.

scholarly journals Tolerance of preterm formula versus pasteurized donor human milk in very preterm infants: a randomized non-inferiority trial

2018 ◽  
Vol 44 (1) ◽  
Author(s):  
Simonetta Costa ◽  
Luca Maggio ◽  
Giovanni Alighieri ◽  
Giovanni Barone ◽  
Francesco Cota ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Donor Human Milk ◽  
Preterm Formula

scholarly journals Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

2018 ◽  
Author(s):  
Eduardo Villamor-Martínez ◽  
Maria Pierro ◽  
Giacomo Cavallaro ◽  
Fabio Mosca ◽  
Boris W. Kramer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Human Milk ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Observational Studies ◽  
Meta Analysis ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Donor Human Milk ◽  
Preterm Formula

Bronchopulmonary dysplasia (BPD) is the most common complication after preterm birth. Pasteurized donor human milk (DHM) has increasingly become the standard of care for very preterm infants over the use of preterm formula (PF) if mother’s own milk (MOM) is unavailable. Studies have reported beneficial effects of DHM on BPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies on the effects of DHM on BPD and other respiratory outcomes. Eighteen studies met the inclusion criteria. Meta-analysis of RCT’s could not demonstrate that supplementation of MOM with DHM reduced BPD when compared to PF (3 studies, risk ratio [RR] 0.89, 95% confidence interval [CI] 0.60–1.32). However, meta-analysis of observational studies showed that DHM supplementation reduced BPD (8 studies, RR 0.78, 95% CI 0.67–0.90). An exclusive human milk diet reduced the risk of BPD, compared to a diet with PF and/or bovine milk-based fortifier (3 studies, RR 0.80, 95% CI 0.68–0.95). Feeding raw MOM, compared to feeding pasteurized MOM, protected against BPD (2 studies, RR 0.77, 95% CI 0.62–0.96). In conclusion, our data suggest that DHM protects against BPD in very preterm infants, but pasteurization of human milk reduces the benefit.

scholarly journals Nutrition for Preterm Infants: 75 Years of History

2018 ◽  
Vol 72 (Suppl. 3) ◽  
pp. 25-31 ◽  
Author(s):  
Johannes B. van Goudoever
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Survival Rates ◽  
Primary Source ◽  
Alternative Methods ◽  
Donor Human Milk ◽  
Aids Epidemic ◽  
Preterm Formula ◽  
Short And Long Term

As technology has advanced, survival rates of preterm infants have improved dramatically. Human milk was the primary source of enteral nutrition during the early days of neonatology, but the HIV/AIDS epidemic resulted in an increased use of preterm formula. More recently, the benefits of human milk were rediscovered, resulting in increased use of donor human milk as well. The awareness that human milk does not contain the amounts of nutrients to meet the high requirements of infants born premature resulted in the development of human milk fortifiers. The development of these fortifiers is still ongoing, as are alternative methods of pasteurization of donor milk. Those initiatives will increase the use of human milk with consequently short- and long-term benefits for preterm infants.

scholarly journals A Systematic Review and Meta-Analysis of Human Milk Feeding and Short-Term Growth in Preterm and Very Low Birth Weight Infants

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2089
Author(s):  
Machiko Suganuma ◽  
Alice R. Rumbold ◽  
Jacqueline Miller ◽  
Yan Fong Chong ◽  
Carmel T. Collins
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Meta Analysis ◽  
Poor Quality ◽  
Low Birth Weight Infants ◽  
Preterm Formula ◽  
Meta Analyses

Human milk (HM) is the gold standard for feeding infants but has been associated with slower growth in preterm infants compared with preterm formula. This systematic review and meta-analysis summarises the post-1990 literature to examine the effect of HM feeding on growth during the neonatal admission of preterm infants with birth weight ≤1500 g and/or born ≤28 weeks’ gestation. Medline, PubMed, CINAHL, and Scopus were searched, and comparisons were grouped as exclusive human milk (EHM) vs. exclusive preterm formula (EPTF), any HM vs. EPTF, and higher vs. lower doses of HM. We selected studies that used fortified HM and compared that with a PTF; studies comparing unfortified HM and term formula were excluded. Experimental and observational studies were pooled separately. The GRADE system was used to evaluate risk of bias and certainty of evidence. Forty-four studies were included with 37 (n = 9963 infants) included in the meta-analyses. In general, due to poor quality studies, evidence of the effect of any HM feeds or higher versus lower doses of HM was inconclusive. There was a possible effect that lower doses of HM compared with higher doses of HM improved weight gain during the hospital admission, and separately, a possible effect of increased head circumference growth in infants fed EPTF vs. any HM. The clinical significance of this is unclear. There was insufficient evidence to determine the effects of an exclusive HM diet on any outcomes.

scholarly journals Impact of Donor Human Milk in the Preterm Very Low Birth Weight Gut Transcriptome Profile by Use of Exfoliated Intestinal Cells

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2677 ◽  
Author(s):  
Anna Parra-Llorca ◽  
María Gormaz ◽  
Sheila Lorente-Pozo ◽  
Maria Cernada ◽  
Ana García-Robles ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Principal Component ◽  
Postnatal Period ◽  
Intestinal Cells ◽  
Donor Human Milk ◽  
Genome Wide ◽  
Alpha Gene ◽  
Cytosolic Factor

Background: Own mother’s milk (OMM) is the optimal nutrition for preterm infants. However, pasteurized donor human milk (DHM) is a valid alternative. We explored the differences of the transcriptome in exfoliated epithelial intestinal cells (EEIC) of preterm infants receiving full feed with OMM or DHM. Methods: The prospective observational study included preterm infants ≤ 32 weeks’ gestation and/or ≤1500 g birthweight. Total RNA from EEIC were processed for genome-wide expression analysis. Results: Principal component analysis and unsupervised hierarchical clustering analysis revealed two clustered groups corresponding to the OMM and DHM groups that showed differences in the gene expression profile in 1629 transcripts. The OMM group overexpressed lactalbumin alpha gene (LALBA), Cytochrome C oxidase subunit I gene (COX1) and caseins kappa gene (CSN3), beta gene (CSN2) and alpha gene (CSN1S1) and underexpressed Neutrophil Cytosolic Factor 1 gene (NCF1) compared to the DHM group. Conclusions: The transcriptomic analysis of EEIC showed that OMM induced a differential expression of specific genes that may contribute to a more efficient response to a pro-oxidant challenge early in the postnatal period when preterm infants are at a higher risk of oxidative stress. The use of OMM should be strongly promoted in preterm infants.

scholarly journals Breast Milk Iodine Concentration Is Associated with Infant Growth, Independent of Maternal Weight

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 358 ◽  
Author(s):  
Lindsay Ellsworth ◽  
Harlan McCaffery ◽  
Emma Harman ◽  
Jillian Abbott ◽  
Brigid Gregg
Keyword(s):  
Breast Milk ◽  
Weight Status ◽  
Post Partum ◽  
Iodine Content ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Infant Growth ◽  
Maternal Weight ◽  
Significant Difference ◽  
Pregnancy Weight

In breastfed infants, human milk provides the primary source of iodine to meet demands during this vulnerable period of growth and development. Iodine is a key micronutrient that plays an essential role in hormone synthesis. Despite the importance of iodine, there is limited understanding of the maternal factors that influence milk iodine content and how milk iodine intake during infancy is related to postnatal growth. We examined breast milk samples from near 2 weeks and 2 months post-partum in a mother-infant dyad cohort of mothers with pre-pregnancy weight status defined by body mass index (BMI). Normal (NW, BMI < 25.0 kg/m2) is compared to overweight/obesity (OW/OB, BMI ≥ 25.0 kg/m2). The milk iodine concentration was determined by inductively coupled plasma mass spectrometry. We evaluated the associations between iodine content at 2 weeks and infant anthropometrics over the first year of life using multivariable linear mixed modeling. Iodine concentrations generally decreased from 2 weeks to 2 months. We observed no significant difference in iodine based on maternal weight. A higher iodine concentration at 2 weeks was associated with a larger increase in infant weight-for-age and weight-for-length Z-score change per month from 2 weeks to 1 year. This pilot study shows that early iodine intake may influence infant growth trajectory independent of maternal pre-pregnancy weight status.

Donor Human Milk for Preterm Infants

PEDIATRICS ◽  
2012 ◽  
Vol 130 (2) ◽  
pp. e462-e462 ◽  
Author(s):  
W. McGuire
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Donor Human Milk

scholarly journals Gender influence on body composition in preterm infants fed human milk or preterm formula

1999 ◽  
Vol 45 (6) ◽  
pp. 913-913 ◽  
Author(s):  
C Pieltain ◽  
M De Curtis ◽  
F Studinski ◽  
J Rigo
Keyword(s):  
Body Composition ◽  
Human Milk ◽  
Preterm Infants ◽  
Gender Influence ◽  
Preterm Formula

Donor human milk for preterm infants: Practice considerations

2013 ◽  
Vol 19 (4) ◽  
pp. 175-181 ◽  
Author(s):  
Sharyn Gibbins ◽  
Sabrina E. Wong ◽  
Sharon Unger ◽  
Deborah O'Connor
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Donor Human Milk
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