scholarly journals Effects of Total Enteral Nutrition on Early Growth, Immunity, and Neuronal Development of Preterm Infants

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2755
Author(s):  
Zakir Hossain ◽  
Wafaa A Qasem ◽  
James K. Friel ◽  
Abdelwahab Omri
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Neuronal Development ◽  
Early Growth ◽  
Trace Minerals ◽  
Immune Protection ◽  
Neurodevelopmental Outcomes ◽  
Total Enteral Nutrition ◽  
Sodium Zinc

The feeding of colostrum and mother’s transitional milk improves immune protection and neurodevelopmental outcomes. It also helps with gut maturation and decreases the risks of infection. The supply of nutrients from human milk (HM) is not adequate for preterm infants, even though preterm mother’s milk contains higher concentrations of protein, sodium, zinc, and calcium than mature HM. The human milk fortifiers, particularly those with protein, calcium, and phosphate, should be used to supplement HM to meet the necessities of preterm infants. The management of fluid and electrolytes is a challenging aspect of neonatal care of preterm infants. Trace minerals such as iron, zinc, copper, iodine, manganese, molybdenum, selenium, chromium, and fluoride are considered essential for preterm infants. Vitamins such as A, D, E, and K play an important role in the prevention of morbidities, such as bronchopulmonary dysplasia, retinopathy of prematurity, and intraventricular hemorrhage. Therefore, supplementation of HM with required nutrients is recommended for all preterm infants.

scholarly journals Germinal Matrix-Intraventricular Hemorrhage: A Tale of Preterm Infants

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Walufu Ivan Egesa ◽  
Simon Odoch ◽  
Richard Justin Odong ◽  
Gloria Nakalema ◽  
Daniel Asiimwe ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Preterm Neonates ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes ◽  
Germinal Matrix ◽  
Posthemorrhagic Hydrocephalus ◽  
Management Interventions ◽  
Incidence Risk

Germinal matrix-intraventricular hemorrhage (GM-IVH) is a common intracranial complication in preterm infants, especially those born before 32 weeks of gestation and very-low-birth-weight infants. Hemorrhage originates in the fragile capillary network of the subependymal germinal matrix of the developing brain and may disrupt the ependymal lining and progress into the lateral cerebral ventricle. GM-IVH is associated with increased mortality and abnormal neurodevelopmental outcomes such as posthemorrhagic hydrocephalus, cerebral palsy, epilepsy, severe cognitive impairment, and visual and hearing impairment. Most affected neonates are asymptomatic, and thus, diagnosis is usually made using real-time transfontanellar ultrasound. The present review provides a synopsis of the pathogenesis, grading, incidence, risk factors, and diagnosis of GM-IVH in preterm neonates. We explore brief literature related to outcomes, management interventions, and pharmacological and nonpharmacological prevention strategies for GM-IVH and posthemorrhagic hydrocephalus.

scholarly journals Human Milk Feeding and Preterm Infants’ Growth and Body Composition: A Literature Review

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1155 ◽  
Author(s):  
Jacopo Cerasani ◽  
Federica Ceroni ◽  
Valentina De Cosmi ◽  
Alessandra Mazzocchi ◽  
Daniela Morniroli ◽  
...  
Keyword(s):  
Body Composition ◽  
Literature Review ◽  
Human Milk ◽  
Preterm Infants ◽  
Cost Effective ◽  
Postnatal Growth ◽  
Fat Free Mass ◽  
Neurodevelopmental Outcomes ◽  
Adverse Health Outcomes ◽  
Milk Feeding

Preterm infants may show a higher risk of adverse health outcomes, such as the development of metabolic syndrome and cognitive impairment. The most recent evidence highlights that nutrition, body composition development, and early postnatal growth may play a role in the programming of these processes. Human milk feeding has been recommended as the natural feeding for preterm infants and as a cost-effective strategy for reducing disease and economic burden. Considering that the postnatal growth retardation and aberrant body composition shown by preterm infants at the time of hospital discharge still remain important issues, we performed a literature review, aiming to provide an update about the effect of human milk feeding on these processes. On the basis of our findings, human milk feeding in preterm infants, although related to a slower weight gain than formula feeding, is associated with a better recovery of body composition through the promotion of fat-free mass deposition, which may ultimately lead to better metabolic and neurodevelopmental outcomes. Promotion and support of human milk feeding should be considered a priority in preterm infants’ care.

Neurodevelopmental Outcomes of Preterm Infants Fed Human Milk

2017 ◽  
Vol 44 (1) ◽  
pp. 69-83 ◽  
Author(s):  
Beatrice E. Lechner ◽  
Betty R. Vohr
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Neurodevelopmental Outcomes

Intraventricular Hemorrhage and Neurodevelopmental Outcomes in Extreme Preterm Infants

PEDIATRICS ◽  
2013 ◽  
Vol 133 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Srinivas Bolisetty ◽  
Anjali Dhawan ◽  
Mohamed Abdel-Latif ◽  
Barbara Bajuk ◽  
Jacqueline Stack ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Neurodevelopmental Outcomes

scholarly journals The “Fortilat” Randomized Clinical Trial Follow-Up: Neurodevelopmental Outcome at 18 Months of Age

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3807
Author(s):  
Chiara Peila ◽  
Elena Spada ◽  
Sonia Deantoni ◽  
Ester Iuliano ◽  
Guido E. Moro ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Human Milk ◽  
Preterm Infants ◽  
Bovine Milk ◽  
Wilcoxon Test ◽  
Protein Supplement ◽  
Donkey Milk ◽  
Neurodevelopmental Outcomes

Adequate nutrition is fundamental to neonatal survival and short-term outcomes, but it also has long-term consequences on quality of life and neurologic development of preterm infants. Donkey milk has been suggested as a valid alternative for children allergic to cows’ milk proteins, due to its biochemical similarity to human milk; we, hence, hypothesized that donkey milk could be a suitable basis for developing an innovative human milk fortifier for feeding preterm infants. The aim of the current study was to extend the findings and to evaluate the neurodevelopmental outcomes at 18 months of corrected age of the infants enrolled in the clinical trial named “Fortilat”. Infants born ≤1500 g and <32 weeks of gestational age were randomized to receive either a combination of bovine milk-based multicomponent fortifier and protein supplement or a combination of a novel multicomponent fortifier and protein supplement derived from donkey milk. The followed fortification protocol was the same for the two groups and the two diets were designed to be isoproteic and isocaloric. All infants enrolled were included in a developmental assessment program. The neurodevelopmental assessment was performed at 18 ± 6 months of corrected age. Minor and major neurodevelopmental impairment and General Quotient (GQ) at the Griffiths-II Mental Development Scale were considered. The GQ was considered both in continuous and as two classes: lower than and higher than (or equal to) a defined cutoff (GQcl). The difference in GQ and GQcl between the two arms was estimated using Mann–Whitney–Wilcoxon test or Fischer exact test, respectively, on the assumption of casual loss at follow-up. A further analysis was performed using generalized linear models. There were 103 children (bovine milk-derived fortifier arm = 54, donkey milk-derived fortifier arm = 49) included for the neurodevelopmental follow-up. All observations were included in the interval of 18 ± 6 months of corrected age. No significant difference was observed between the two arms in the incidence of neurologic sequelae and the GQs were similar in the two arms. Our results demonstrated no difference for the donkey milk-derived fortifier compared to standard bovine-derived fortifier regarding long-term neurodevelopmental outcomes.

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