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 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.

Body Composition of Very Low‐Birth‐Weight Infants Fed Fortified Human Milk: A Pilot Study

2020 ◽  
Author(s):  
Kera McNelis ◽  
Chunyan Liu ◽  
Shelley Ehrlich ◽  
Christopher Fields ◽  
Trayce Fields ◽  
...  
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Pilot Study ◽  
Low Birth Weight ◽  
Human Milk ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants

scholarly journals Effect of targeted vs standard fortification of breast milk on growth and development of preterm infants (≤ 32 weeks): study protocol for a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Joanna Seliga-Siwecka ◽  
Anna Chmielewska ◽  
Katarzyna Jasińska
Keyword(s):  
Randomized Controlled Trial ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Low Birth Weight Infants ◽  
Randomized Controlled ◽  
Link Type

Abstract Background Human milk is recommended for all very low birth weight infants. Breastmilk is highly variable in nutrient content, failing to meet the nutritional demands of this group. Fortification of human milk is recommended to prevent extrauterine growth retardation and associated poor neurodevelopmental outcome. However, standard fortification with fixed dose multicomponent fortifier does not account for the variability in milk composition. Targeted fortification is a promising alternative and needs further investigation. Methods This randomized controlled trial will recruit preterm infants (≤ 32 weeks of gestation) within the first 7 days of life. After reaching 80 ml/kg/day of enteral feeding, patients will be randomized to receive standard fortification (HMF, Nutricia) or targeted fortification (modular components: Bebilon Bialka, Nutricia—protein; Polycal, Nutricia—carbohydrates; Calogen, Nutricia—lipids). The intervention will continue until 37 weeks of post-conception age or hospital discharge. Parents and outcome assessors will be blinded to the intervention. The primary outcome measure is velocity of weight, length, and head growth until 36 weeks post-conceptional age or discharge. Secondary outcomes include neurodevelopment at 12 months assessed with Bayley Scale of Development III, repeated at 36 months; body composition at discharge and at 4 months; and incidence of necrotizing enterocolitis, sepsis, retinopathy of prematurity, and bronchopulmonary dysplasia. Discussion Targeted fortification has previously been shown as doable in the neonatal intensive care unit context. If it shows to improve growth and neonatal outcome, choosing the targeted fortification as a first line nutritional approach in very low birth weight infants may become a recommendation. Trial registration ClinicalTrials.govNCT03775785, Registered on July 2019.

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.

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.

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 Human Milk Improves Motor Development of Very Low Birth Weight Infants during Early Infancy

1999 ◽  
Vol 45 (4, Part 2 of 2) ◽  
pp. 120A-120A ◽  
Author(s):  
Jo-Ann B Bier ◽  
Tanya L Oliver ◽  
Anne Ferguson ◽  
Michelle R Tremont ◽  
Michael E Msall ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Human Milk ◽  
Motor Development ◽  
Very Low Birth Weight ◽  
Early Infancy ◽  
Low Birth Weight Infants
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