scholarly journals Targeted Breast Milk Fortification for Very Low Birth Weight (VLBW) Infants: Nutritional Intake, Growth Outcome and Body Composition

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1156 ◽  
Author(s):  
Sumesh Parat ◽  
Praneeta Raza ◽  
May Kamleh ◽  
Dennis Super ◽  
Sharon Groh-Wargo
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Breast Milk ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Protein Intake ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Standard Group ◽  
Low Birth Weight Infants

Despite improvements in nutritional management, preterm infants continue to face high rates of postnatal growth restriction. Because variability in breast milk composition may result in protein and energy deficits, targeted fortification has been advocated. We conducted an interventional study to compare body composition and growth outcomes of very low birth weight infants fed targeted protein-fortified human milk (HM) with those fed standard fortified HM. If mother’s own milk was not available, donor milk was used. Weekly analysis of HM with mid-infrared spectroscopy was conducted and additional protein was added to the fortified HM to ensure a protein intake of 4 g/kg/day. Weekly anthropometric measurements were done. Prior to discharge or at 37 weeks, corrected age skinfold thickness (SFT) measurements as well as body composition measurement using air displacement plethysmography were done. Among 36 preterm infants enrolled, those in the targeted group (n = 17) received more protein and had a larger flank SFT at study end than those in the standard group (n = 19). A pilot post-hoc analysis of subjects having at least 30 intervention days showed a 3% higher fat-free mass in the targeted group. Use of a targeted fortification strategy resulted in a higher protein intake and fat-free mass among those receiving longer intervention.

scholarly journals Energy Expenditure, Protein Oxidation and Body Composition in a Cohort of Very Low Birth Weight Infants

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3962
Author(s):  
Michela Perrone ◽  
Camilla Menis ◽  
Pasqua Piemontese ◽  
Chiara Tabasso ◽  
Domenica Mallardi ◽  
...  
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Energy Expenditure ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Protein Oxidation ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Low Birth Weight Infants

The nutritional management of preterm infants is a critical point of care, especially because of the increased risk of developing extrauterine growth restriction (EUGR), which is associated with worsened health outcomes. Energy requirements in preterm infants are simply estimated, so the measurement of resting energy expenditure (REE) should be a key point in the nutritional evaluation of preterm infants. Although predictive formulae are available, it is well known that they are imprecise. The aim of our study was the evaluation of REE and protein oxidation (Ox) in very low birth weight infants (VLBWI) and the association with the mode of feeding and with body composition at term corrected age. Methods: Indirect calorimetry and body composition were performed at term corrected age in stable very low birth weight infants. Urinary nitrogen was measured in spot urine samples to calculate Ox. Infants were categorized as prevalent human milk (HMF) or prevalent formula diet (PFF). Results: Fifty VLBWI (HMF: 23, PFF: 27) were evaluated at 36.48 ± 0.85 post-conceptional weeks. No significant differences were found in basic characteristics or nutritional intake in the groups at birth and at the assessment. No differences were found in the REE of HMF vs. PFF (59.69 ± 9.8 kcal/kg/day vs. 59.27 ± 13.15 kcal/kg/day, respectively). We found statistical differences in the protein-Ox of HMF vs. PFF (1.7 ± 0.92 g/kg/day vs. 2.8 ± 1.65 g/kg/day, respectively, p < 0.01), and HMF infants had a higher fat-free mass (kg) than PFF infants (2.05 ± 0.26 kg vs. 1.82 ± 0.35 kg, respectively, p < 0.01), measured with air displacement plethysmography. Conclusion: REE is similar in infants with a prevalent human milk diet and in infants fed with formula. The HMF infants showed a lower oxidation rate of proteins for energy purposes and a better quality of growth. A greater amount of protein in HMF is probably used for anabolism and fat-free mass deposition. Further studies are needed to confirm our hypothesis.

scholarly journals Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 145 ◽  
Author(s):  
Sara E. Ramel ◽  
Jacob Haapala ◽  
Jennifer Super ◽  
Christopher Boys ◽  
Ellen W. Demerath
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Neurodevelopmental Outcomes ◽  
Prospective Longitudinal Study ◽  
Z Scores ◽  
Prospective Longitudinal

Preterm infants have altered body composition compared to term infants, which impacts both neurodevelopment and metabolic health, but whether increased dietary intake during hospitalization, independent of illness, may improve body composition is unknown. This prospective, longitudinal study (n = 103) measured fat-free mass (FFM) and percent body fat (%BF) at discharge and four months corrected age for prematurity (CA) in very low birth weight (VLBW) preterm infants. Markers of illness and macronutrient intakes (protein and caloric) were recorded. Bayley Scales of Infant Development-III (BSID) were administered at 12 and 24 months of age in a subset of these infants (n = 66 and n = 50 respectively). Body composition z-scores were calculated using recently developed reference curves. Linear regression was used to test the associations between clinical factors and body composition z-scores, as well as z-scores and BSID scores. Increased calories and protein received in the first week after birth and protein intake throughout hospitalization were associated with increased FFM z-scores at discharge, but not with %BF z-scores. After adjustment for both early acute and chronic illness, associations of nutrient intake with FFM z-score remained unchanged. FFM z-scores at discharge were positively associated with scores on the BSID at 12 and 24 months CA. In conclusion, increased energy and protein intakes both early in hospitalization and across its entire duration are associated with higher FFM at discharge, a key marker for organ growth and neurodevelopment in the VLBW neonate. Optimizing caloric intake, irrespective of illness is critical for enhancing body composition, and by extension, neurodevelopmental outcomes for preterm infants.

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

Pulse dexamethasone does not impair growth and body composition of very low birth weight infants.

1995 ◽  
Vol 14 (5) ◽  
pp. 455-462 ◽  
Author(s):  
C H Gilmour ◽  
J M Sentipal-Walerius ◽  
J G Jones ◽  
J M Doyle ◽  
B S Brozanski ◽  
...  
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Pulse Dexamethasone

scholarly journals The effects of varying protein and energy intakes on the growth and body composition of very low birth weight infants

2011 ◽  
Vol 10 (1) ◽  
Author(s):  
Juan Antonio Costa-Orvay ◽  
Josep Figueras-Aloy ◽  
Gerardo Romera ◽  
Ricardo Closa-Monasterolo ◽  
Xavier Carbonell-Estrany
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants

Eleven Plasma Proteins as Indicators of Protein Nutritional Status in Very Low Birth Weight Infants

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 916-921 ◽  
Author(s):  
Staffan K. T. Polberger ◽  
Göran A. Fex ◽  
Irene E. Axelsson ◽  
Niels C. R. Räihä
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Nutritional Status ◽  
Protein Intake ◽  
Plasma Proteins ◽  
Very Low Birth Weight ◽  
Binding Protein ◽  
Plasma Concentrations ◽  
Retinol Binding Protein ◽  
Low Birth Weight Infants

Concentrations of 11 plasma proteins were measured in 28 healthy, growing, very low birth weight, appropriate-for-gestational-age infants fed varying levels of human milk protein intake (range 1.7 to 3.9 g/kg per day). Significant positive correlations were found between ween mean protein intake and concentrations of 7 of the plasma proteins studied (transthyretin, retinol-binding protein, and transferrin: P &lt; .001; vitamin D-binding protein and apolipoprotein B: P &lt; .01; albumin and apolipoprotein A I: P &lt; .05). A weak negative correlation with mean protein intake was seen for the plasma level of orosomucoid, whereas no significant correlations were found for the plasma concentrations of fibronectin and α1-antichymotrypsin. Protein intake, not energy intake, constituted the main contribution to the changes in the concentrations of transthyretin, retinol-binding protein, and transferrin. The levels of plasma transthyretin and transferrin were also strongly correlated with weight and length growth of the infants during the study as well as with other indicators of protein nutritional status such as preprandial concentrations of plasma amino acids and serum and urine urea. These data indicate that of the 11 plasma proteins studied, transthyretin, transferrin, and retinol-binding protein are the most suitable to evaluate protein nutritional status in very low birth weight infants.

Higher Incidence Rates of Hypothyroidism and Late TSH Rise in Preterm Very-Low-Birth-Weight Infants at a Tertiary Care Center

2018 ◽  
Vol 89 (4) ◽  
pp. 224-232 ◽  
Author(s):  
Hala Tfayli ◽  
Lama Charafeddine ◽  
Hani Tamim ◽  
Joanne Saade ◽  
Rose T. Daher ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Newborn Screening ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Care Center ◽  
Compliance Rate ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Low Birth Weight Infants

Background/Aims: Preterm newborns with a very low birth weight (VLBW) of < 1,500 g have an atypical form of hypothyroidism with a delayed rise in TSH, necessitating a second newborn screening specimen collection. The aims of this study were to survey the compliance with second newborn screening to detect delayed TSH rise in VLBW preterm infants at a tertiary care center, and to determine the rate of atypical hypothyroidism. Methods: Retrospective review of the records of 104 preterm VLBW infants. Late TSH rise was defined as an increase in TSH concentration after 14 days of age in the presence of a normal initial screen. Results: The compliance rate was 92% for the second screening. High rates of hypothyroidism (16.3%) and of late TSH rise (4.8%) were detected. Patients with hypothyroidism had a significantly lower birth weight (p = 0.01) and longer hospital stay (p = 0.004). Patients with late versus those with early TSH rise had a significantly lower mean birth weight (851 ± 302 vs. 1,191 ± 121 g, p = 0.004). Conclusion: The rates of early and late TSH rise in this VLBW population were higher than those in the literature and could be due to the use of povidone-iodine disinfectants. The yield of a second TSH screening in this study was high indicating the need for vigilance in screening VLBW preterm infants.

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