scholarly journals Effects on Gastroesophageal Reflux of Donkey Milk-Derived Human Milk Fortifier Versus Standard Fortifier in Preterm Newborns: Additional Data from the FortiLat Study

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2142 ◽  
Author(s):  
Francesco Cresi ◽  
Elena Maggiora ◽  
Alice Pirra ◽  
Paola Tonetto ◽  
Carlotta Rubino ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gastric Emptying ◽  
Gastroesophageal Reflux ◽  
Human Milk ◽  
Preterm Infants ◽  
Feeding Intolerance ◽  
Donkey Milk ◽  
Gastric Emptying Time ◽  
Human Milk Fortifier ◽  
Emptying Time

Background: Feeding intolerance is a frequent diagnosis in very preterm infants. As seen in the FortiLat trial, human milk fortification with the new donkey milk-derived human milk fortifier (DF) seems to improve feeding tolerance in these infants. The aim of this study was to evaluate the effects of using the DF compared with bovine milk-derived fortifier (BF) on gastroesophageal reflux (GER) in very low birth weight (VLBW) infants. Methods: Over a total of 156 preterm infants were enrolled into the FortiLat trial (GA <32 weeks and birth weight <1500 g) and randomized into the BF arm or DF arm, and we selected all infants with clinical signs of GER and cardiorespiratory (CR) symptoms. All the infants underwent CR and multichannel intraluminal impedance and pH (MII/pH) monitoring associated with gastric ultrasound to evaluate GER and gastric emptying time. Results: 10 infants were enrolled, and 5 were in the DF arm. At MII/pH, infants enrolled into the DF arm showed a lower GER frequency than BF arm infants (p = 0.036). Half gastric emptying time was similar in DF and BF arm infants (p = 0.744). Conclusion: The use of donkey-derived human milk fortifier reduced the GER frequency and consequently should be recommended in infants with feeding intolerance.

scholarly journals Effects on gastroesophageal reflux of donkey milk-derived human milk fortifier versus standard fortifier in preterm newborns. Additional data from Fortilat study.

2020 ◽  
Author(s):  
Francesco Cresi ◽  
Elena Maggiora ◽  
Alice Pirra ◽  
Paola Tonetto ◽  
Carlotta Rubino ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Gastroesophageal Reflux ◽  
Human Milk ◽  
Preterm Infants ◽  
Ph Monitoring ◽  
Bovine Milk ◽  
Clinical Signs ◽  
Donkey Milk ◽  
Symptom Association Probability ◽  
Human Milk Fortifier

Abstract Background : Feeding intolerance, defined as the inability to digest enteral feeding, is a frequent diagnosis in very preterm infants. It is characterized by abdominal distension, delayed gastric emptying and increased frequency and severity of gastroesophageal reflux (GER). As seen in the FortiLat trial, human milk fortification with the new donkey milk-derived human milk fortifier (DF) seems to improve feeding tolerance in these infants. The aim of this ancillary study of the FortiLat trial was to evaluate the effects of using the DF compared with bovine milk-derived fortifier (BF) on GER in VLBW infants.Methods : Over a total of 156 preterm infants enrolled into the FortiLat trial (gestational age <32 weeks and/or birth weight <1500 g) and randomized into BF-arm or DF-arm we selected all infants with clinical signs of GER and cardiorespiratory (CR) symptoms at day 21 of fortification. All the infants underwent CR and multichannel intraluminal impedance and pH (MII/pH) monitoring associated with gastric ultrasound to evaluate GER characteristics, GER-CR temporal associations and gastric emptying time.Results : 10 infants were enrolled, 5 in the DF-arm. At MII/pH infants enrolled into the DF-arm showed a lower GER frequency than BF-arm infants: 2.02(1.95-3.26) vs 4.82(2.84-5.94) GER/hour (p=0.036). No infant had a significant symptom association probability index between GER and CR events. Half gastric emptying time was similar in DF and BF-arm infants: 45.03(42.74-47.02) vs. 48.57(44.73-48.77) min. (p=0.744)Conclusions : The use of donkey derived human milk fortifier reduced the GER frequency and consequently should be recommended in infants with feeding intolerance.Trial Registration : ISRCTN -ISRCTN70022881. Registered 01May 2014 - Retrospectively registered, http://www.isrctn.com/ISRCTN70022881

scholarly journals A Novel Donkey Milk–derived Human Milk Fortifier in Feeding Preterm Infants

2019 ◽  
Vol 68 (1) ◽  
pp. 116-123 ◽  
Author(s):  
Enrico Bertino ◽  
Laura Cavallarin ◽  
Francesco Cresi ◽  
Paola Tonetto ◽  
Chiara Peila ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Donkey Milk ◽  
Human Milk Fortifier

scholarly journals Comparison of Very Low Birth Weight Preterm Infants with And Without Experienced Target Weight Gain on The Administration of Human Milk Fortifier

2020 ◽  
Vol 6 (3) ◽  
pp. 79-85
Author(s):  
Diondra Eka Rizkiawan ◽  
Adhie Nur Radityo ◽  
Rina Pratiwi ◽  
Kusmiyati Tjahjono
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Clinical Symptoms ◽  
Control Group ◽  
Characteristic Difference ◽  
Human Milk Fortifier

Background: Human milk fortifier (HMF) is defined as a supplement added to breastmilk to increase calories, proteins, vitamins, and various nutrition of breastmilk. The purpose of HMF administration is to increase the concentration of breastmilk nutrients to improve the weight of very low birth weight preterm infants. The administration of HMF is insufficient to fulfill protein needs in 20-40% very low birth weight babies, thus the weight gain did not meet the expected target.Objective: To analyze characteristic differences between very low birth weight preterm infants who experienced weight gain according to the target and not according to the target on the administration of HMF.Methods: An analytical study with a case-control approach comparing case and control group, which was observed to determine characteristic differences between both groups. The samples were 52 very low birth weight preterm infants obtained by consecutive sampling. Data analysis includes descriptive analysis and hypothesis testing. Results: Data were obtained from medical records and consisted of 52 participants, including 26 very low birth weight premature infants who experienced weight gain according to the target and 26 who experienced weight gain not according to the target. There was no characteristic difference of cyanosis clinical symptoms (OR 2.3; 95% CI 0.51-10.4), chest retraction (OR 1.0; 95% CI 0.32-3.1), apnea of prematurity comorbid (OR 1.0; 95% CI 0.25-3.9), neonatal infections (OR 0.62; 95% CI 0.21-1.9), starting age of HMF administration (OR 0.62; 95% CI 0.21-1.89), bloating (OR 0.57; 95% CI 0.17-1.9), and vomiting (OR 1.18; 95% CI 0.38-3.7) in both groups.Conclusion: There was no characteristic difference between very low birth weight preterm infants who experienced weight gain according to the target and not according to the target on the administration of HMF.

scholarly journals Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of Feed Intolerance

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1433 ◽  
Author(s):  
Anish Pillai ◽  
Susan Albersheim ◽  
Julie Matheson ◽  
Vikki Lalari ◽  
Sylvia Wei ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Clinical Decision ◽  
Feeding Intolerance ◽  
Serious Adverse Events ◽  
Increased Risk ◽  
Preterm Formula ◽  
Feed Intolerance ◽  
Preterm Babies ◽  
Human Milk Fortifier

There are concerns around safety and tolerance of powder human milk fortifiers to optimize nutrition in preterm infants. The purpose of this study was to evaluate the tolerance and safety of a concentrated preterm formula (CPF) as a liquid human milk fortifier (HMF) for premature infants at increased risk of feeding intolerance. We prospectively enrolled preterm infants over an 18-month period, for whom a clinical decision had been made to add CPF to human milk due to concerns regarding tolerance of powder HMF. Data on feed tolerance, anthropometry, and serum biochemistry values were recorded. Serious adverse events, such as mortality, necrotizing enterocolitis (NEC), and sepsis, were monitored. A total of 29 babies received CPF fortified milk during the study period. The most common indication for starting CPF was previous intolerance to powder HMF. Feeding intolerance was noted in 4 infants on CPF. The growth velocity of infants was satisfactory (15.9 g/kg/day) after addition of CPF to feeds. The use of CPF as a fortifier in preterm babies considered at increased risk for feed intolerance seems well tolerated and facilitates adequate growth. Under close nutrition monitoring, this provides an additional option for human milk fortification in this challenging subgroup of preterm babies, especially in settings with limited human milk fortifier options.

Ultrasound assessment of gastric emptying time in preterm infants

2019 ◽  
Vol 36 (6) ◽  
pp. 406-410 ◽  
Author(s):  
Christiane E. Beck ◽  
Lars Witt ◽  
Lisa Albrecht ◽  
Anne-Mieke Winstroth ◽  
Matthias Lange ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Preterm Infants ◽  
Gastric Emptying Time ◽  
Ultrasound Assessment ◽  
Emptying Time
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