scholarly journals Macronutrient Analysis of Target-Pooled Donor Breast Milk and Corresponding Growth in Very Low Birth Weight Infants

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1884 ◽  
Author(s):  
Ting Ting Fu ◽  
Paige E. Schroder ◽  
Brenda B. Poindexter
Keyword(s):  
Breast Milk ◽  
Low Birthweight ◽  
Near Infrared ◽  
Very Low Birth Weight ◽  
Growth Patterns ◽  
Z Score ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Negative Change ◽  
Z Scores

The macronutrient composition of target-pooled donor breast milk (DBM) (milk combined strategically to provide 20 kcal/oz) and growth patterns of preterm infants receiving it have not been characterized. Caloric target-pooled DBM samples were analyzed by near-infrared spectroscopy. Weekly growth velocities and anthropometric z-scores were calculated for the first 30 days and at 36 weeks corrected gestational age (CGA) for 69 very low birthweight (VLBW) infants receiving minimum one week of DBM. Samples contained mean 18.70 kcal/oz, 0.91 g/dL protein, 3.11 g/dL fat, 7.71 g/dL carbohydrate (n = 96), less than labeled values by 2.43 kcal/oz and 0.11 g/dL protein (p < 0.001). By week 3, growth reached 16.58 g/kg/day, 0.95 cm/week (length), and 1.01 cm/week (head circumference). Infants receiving <50% vs. >50% DBM had similar growth, but infants receiving >50% DBM were more likely to receive fortification >24 kcal/oz (83% vs. 51.9% in the <50% DBM group; p = 0.005). From birth to 36 weeks CGA (n = 60), there was a negative z-score change across all parameters with the greatest in length (−1.01). Thus, target-pooling does not meet recommended protein intake for VLBW infants. Infants fed target-pooled DBM still demonstrate a disproportionate negative change in length z-score over time.

scholarly journals Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2869
Author(s):  
Ting Ting Fu ◽  
Heather C. Kaplan ◽  
Trayce Fields ◽  
Alonzo T. Folger ◽  
Katelyn Gordon ◽  
...  
Keyword(s):  
Birth Weight ◽  
Breast Milk ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Average Weight ◽  
Protein Enrichment ◽  
Z Score ◽  
Low Birth Weight Infants ◽  
Poor Growth ◽  
Vlbw Infants

Protein content is often inadequate in donor breast milk (DBM), resulting in poor growth. The use of protein-enriched target-pooled DBM (DBM+) has not been examined. We compared three cohorts of very low birth weight (VLBW) infants, born ≤ 1500 g: DBM cohort receiving > 1-week target-pooled DBM (20 kcal/oz), MBM cohort receiving ≤ 1-week DBM, and DBM+ cohort receiving > 1-week DBM+. Infants followed a standardized feeding regimen with additional fortification per clinical discretion. Growth velocities and z-scores were calculated for the first 4 weeks (n = 69 for DBM, 71 for MBM, 70 for DBM+) and at 36 weeks post-menstrual age (n = 58, 64, 59, respectively). In total, 60.8% MBM infants received fortification >24 kcal/oz in the first 30 days vs. 78.3% DBM and 77.1% DBM+. Adjusting for SGA, length velocity was greater with DBM+ than DBM in week 1. Average weight velocity and z-score change were improved with MBM compared to DBM and DBM+, but length z-score decreased similarly across all groups. Incidences of NEC and feeding intolerance were unchanged between eras. Thus, baseline protein enrichment appears safe in stable VLBW infants. Weight gain is greatest with MBM. Linear growth comparable to MBM is achievable with DBM+, though the overall length trajectory remains suboptimal.

Major cardiorespiratory events do not increase after immunizations, eye exams, and other stressors in most very low birth weight infants

2021 ◽  
pp. 1-8
Author(s):  
B. Sullivan ◽  
S.M. Ahmad ◽  
C.C. Slevin ◽  
R.A. Sinkin ◽  
V.P. Nagraj ◽  
...  
Keyword(s):  
Low Birthweight ◽  
Very Low Birth Weight ◽  
Oxygen Desaturation ◽  
Hernia Surgery ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Inguinal Hernia Surgery ◽  
Before And After ◽  
Bedside Monitor ◽  
Eye Exams

BACKGROUND: Increased cardiorespiratory events with bradycardia and oxygen desaturation have been reported in very low birthweight (VLBW) infants following stressors such as immunizations. These events are difficult to quantify and may be mild. Our group developed an automated algorithm to analyze bedside monitor data from NICU patients for events with bradycardia and prolonged oxygen desaturation (BDs) and used this to compare BDs 24 hours before and after potentially stressful interventions. METHODS: We included VLBW infants from 2012–2017 with data available around at least one of four interventions: two-month immunizations, retinopathy of prematurity (ROP) examinations, ROP therapy, and inguinal hernia surgery. We used a validated algorithm to analyze electrocardiogram heart rate and pulse oximeter saturation data (HR, SpO2) to quantify BD events of HR <  100 beats/minute for≥4 seconds with oxygen desaturation <  80%SpO2 for≥10 seconds. BDs were analyzed 24 hours before and after interventions using Wilcoxon rank-sum tests. RESULTS: In 354 of 493 (72%) interventions, BD frequency stayed the same or decreased in the 24 hours after the event. An increase of at least five BD’s occurred in 17/146 (12%) after immunizations, 85/290 (29%) after ROP examinations, 4/33 (12%) after ROP therapy, and 3/25 (12%) after hernia surgery. Infants with an increase in BDs after interventions had similar demographics compared to those without. More infants with an increase in BDs following immunizations were on CPAP or caffeine than those without. CONCLUSIONS: Most VLBW infants in our cohort had no increase in significant cardiorespiratory events in the 24 hours following potentially stressful interventions.

Serum triglycerides of breast milk fed very low birth weight infants

1995 ◽  
Vol 28 (3) ◽  
pp. 323-324
Author(s):  
T.R. Fenton ◽  
N. Singhal ◽  
R.D. Baynton ◽  
A.R. Akierman
Keyword(s):  
Birth Weight ◽  
Breast Milk ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Serum Triglycerides

Sequence analyses of variable cytomegalovirus genes for distinction between breast milk- and transfusion-transmitted infections in very-low-birth-weight infants

Transfusion ◽  
2018 ◽  
Vol 58 (12) ◽  
pp. 2894-2902 ◽  
Author(s):  
Yasumi Furui ◽  
Naoji Yamagishi ◽  
Ichiro Morioka ◽  
Rikizo Taira ◽  
Kosuke Nishida ◽  
...  
Keyword(s):  
Birth Weight ◽  
Breast Milk ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Sequence Analyses ◽  
Low Birth Weight Infants

scholarly journals A Clinical Analysis of Physical and Neurological Development in very Low Birth Weight Infants with MEIR (Massage, Exercises, Intelligence training, and Rehabilitation training)

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Yonghong Deng ◽  
Shulian Wang ◽  
Zhaohui Liu ◽  
Qi Liao ◽  
Yan Zeng
Keyword(s):  
Growth And Development ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Clinical Analysis ◽  
Psychomotor Development ◽  
Control Group ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Development Index ◽  
Rehabilitation Training

Objective: This study aimed to investigate the application of MEIR (Massage, Exercises, Intelligence training, and Rehabilitation training) in Chinese VLBW infants and to observe its effects on infants’ growth and development. Methods: Clinical data of 92 VLBW infants who were treated at the neonatal intensive care unit (NICU) of Loudi Central Hospital were retrospectively analyzed. The patients were grouped as the MEIR group (n=47) and controls (n=45). Physical and neurodevelopment development were compared between the two groups. Results: There were differences in height and weight and head circumference between the two groups at all corrected ages (all P<0.05). Abnormal motions, reflexes, muscular tension, audio-visual reactions, and posture, and the total numbers of abnormalities of 3-, 6-, 9- and 12-corrected month-old infants in the MEIR group were lower than in the control group (all P<0.05). The mental development index and psychomotor development index of 6- and 12- corrected month infants in the MEIR group were higher than in the control group (all P<0.05). Conclusion: MEIR could improve the physical and neurological developments of VLBW infants, reduce the incidence of adverse events, and improve their growth and development.

Early Vital Sign Differences in Very Low Birth Weight Infants with Severe Intraventricular Hemorrhage

2021 ◽  
Author(s):  
Santina A. Zanelli ◽  
Maryam Abubakar ◽  
Robert Andris ◽  
Kavita Patwardhan ◽  
Karen D. Fairchild ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Vital Sign ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Cranial Ultrasound ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Arterial Blood

Objective Severe intraventricular hemorrhage (sIVH, grades 3 and 4) is a serious complication for very low birth weight (VLBW) infants and is often clinically silent requiring screening cranial ultrasound (cUS) for detection. Abnormal vital sign (VS) patterns might serve as biomarkers to identify risk or occurrence of sIVH. Study Design This retrospective study was conducted in VLBW infants admitted to two level-IV neonatal intensive care units (NICUs) between January 2009 and December 2018. Inclusion criteria were: birth weight <1.5 kg and gestational age (GA) <32 weeks, at least 12 hours of systemic oxygen saturation from pulse oximetry (SpO2) data over the first 24 hours and cUS imaging. Infants were categorized as early sIVH (sIVH identified in the first 48 hours), late sIVH (sIVH identified after 48 hours and normal imaging in the first 48 hours), and no IVH. Infants with grades 1 and 2 or unknown timing IVH were excluded. Mean heart rate (HR), SpO2, mean arterial blood pressure (MABP), number of episodes of bradycardia (HR < 100 bpm), and desaturation (SpO2 < 80%) were compared. Results A total of 639 infants (mean: 27 weeks' gestation) were included (567 no IVH, 34 early sIVH, and 37 late sIVH). In the first 48 hours, those with sIVH had significantly higher HR compared with those with no IVH. Infants with sIVH also had lower mean SpO2 and MABP and more desaturations <80%. No significant differences in VS patterns were identified in early versus late sIVH. Logistic regression identified higher HR and greater number of desaturations <80% as independently associated with sIVH. Conclusion VLBW infants who develop sIVH demonstrate VS differences with significantly lower SpO2 and higher mean HR over the first 48 hours after birth compared with VLBW infants with no IVH. Abnormalities in early VS patterns may be a useful biomarker for sIVH. Whether VS abnormalities predict or simply reflect sIVH remains to be determined. Key Points

scholarly journals Beneficial Effects of Probiotic Treatment on Gut Microbiota in Very Low Birth Weight Infants

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yue-feng Li ◽  
Chuan-rui Zhu ◽  
Xue-lei Gong ◽  
Hui-ling Li ◽  
Li-kuan Xiong ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gut Microbiota ◽  
Very Low Birth Weight ◽  
Secondary Outcome ◽  
Rrna Gene ◽  
Low Birth Weight Infants ◽  
Microbial Composition ◽  
Vlbw Infants ◽  
Probiotic Treatment

The very low birth weight (VLBW) infant is at great risk for marked dysbiosis of the gut microbiota. In the present study, a total of 36 VLBW infants were randomly divided into two groups, who were treated with combined probiotics and placebo, and 72 fecal specimens on days 14 and 28 of life were collected from them. Finally, 32 fecal specimens extracted from 16 preterm VLBW infants were qualified and analyzed using 16S rRNA gene sequencing. The primary outcome was to evaluate the change of gut microbiota in VLBW infants after combined probiotic supplement. The secondary outcome was to analyze the correlation gut microbial composition and levels of cytokines. We found that probiotic treatment, but not placebo, decreased the α-diversity of gut microbiota in VLBW infants. At the phylum level, probiotic treatment strongly increased the abundance of Firmicutes, whereas that of Proteobacteria was significantly reduced. At the family level, Streptococcaceae and Lactobacillaceae became prevalent after probiotic treatment, while the relative abundance of Enterobacteriaceae was reduced in the meantime. Most notably, significant correlations were observed between Lactobacillaceae abundance and serum cytokine levels. Further studies are required to shed more light on the characteristics of gut microbiota of VLBW neonates. And the modulation of microbiota should be considered to improve the survival rate of VLBW infants.

Pre-discharge growth pattern of very low birth weight infants (VLBW): A 5 year single center experience

2020 ◽  
pp. 1-6
Author(s):  
S.H. Elbeely ◽  
M.A. AlQurashi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Growth Pattern ◽  
Very Low Birth Weight ◽  
Single Center ◽  
Low Birth Weight Infants ◽  
Cross Sectional ◽  
Vlbw Infants ◽  
The Mean

BACKGROUND: Very low birth weight infants born prematurely are at greater risk for growth delays that lead to Ex-utero Growth Restriction (EUGR) during vulnerable periods of organ structural and functional development. There is considerable evidence that early growth failure has adverse effects on long term neurodevelopment in children which often persists into adulthood. METHODS: This is a single-center cross-sectional study on live newborn infants with birth weight ranges from 500 to 1500 grams (VLBW) and gestational age (GA) between 24–32 weeks who were admitted to NICU at KAMC-Jeddah over a 5 year period (2009–2013). This study aims to evaluate predischarge growth pattern of VLBW infants in terms of weight, head circumference (HC) and length and to identify important variables that have influenced such growth pattern. RESULTS: Of the 135 infants included in the final analysis, 68 (50.4%) were male and 67 (49.6%) were female and the mean gestational age was 28.83±2.064 weeks and the mean birth weight 1166.74±256 grams. Ninety-two infants (68%) had discharge weight at ≤10th percentile and forty four (32%) had their weight >10th percentile. HC was the lowest affected among the anthropometric measurements with 42% ≤10th percentile. In terms of linear growth, 62% had their length ≤10th percentile. Amongst infants born ≤750 grams, 71% and 70% had HC and height at ≤10th percentile respectively, at the time of discharge. BPD was significantly associated with EUGR (p = 0.026). CONCLUSIONS: This study demonstrates that almost 2/3rd of VLBW infants born at KAMC-Jeddah with birth weight ≤750 grams were discharged home with EUGR as demonstrated by their weight, length, and HC ≤10th percentile. BPD was found to be significantly associated with EUGR amongst post-natal factors influencing EUGR.

Effect of Breast Milk on Hospital Costs and Length of Stay Among Very Low-Birth-Weight Infants in the NICU

2012 ◽  
Vol 12 (4) ◽  
pp. 254-259 ◽  
Author(s):  
Leslie A. Parker ◽  
Charlene Krueger ◽  
Sandra Sullivan ◽  
Teresa Kelechi ◽  
Martina Mueller
Keyword(s):  
Birth Weight ◽  
Breast Milk ◽  
Length Of Stay ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Hospital Costs ◽  
Low Birth Weight Infants
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