Nutritional supplementation and growth after hospital discharge in very low birthweight newborns: Randomized controlled trial / Suplementação nutricional e crescimento de recém-nascidos de muito baixo peso após alta hospitalar: Ensaio clínico randomizado
DOI:
https://doi.org/10.34117/bjdv7n10-433Keywords:
Breastfeeding, Preterm, Hospital discharge, Growth, Human milk.Abstract
Background Evidence is insufficient to show whether fortification has any effect on growth in preterm infants after discharge. Objective to verify whether VLBW preterm infants who are supplemented with multicomponent present greater anthropometric measurements than those not supplemented. Study Design Parallel randomized controlled trial. A computer-generated random number table was used to allocate the participants. Participants Preterm infants discharged from the NICU of a University Hospital from northeast, Brazil, weighing less than 1,500 g exclusively breastfed at discharge and followed up until they reached 6 months corrected gestational age. Intervention intervention group received Nestlé® PreNan® formula, fractionated in 2 g of powder, mixed with the mother's milk twice a day. Control group was exclusively breastfed. Follow-up was conducted until the infants reached 6 months corrected gestational age (CGA). Outcomes Growth of the anthropometrics parameters weight, head circumference (HC) and lenth with 6 months of corrected age. Mixed effects model for longitudinal data was used. Interaction according to sex was detected and ajusted. Results Weight gain was significantly higher in the intervention group. This effect was verified only for males (p = 0.001). No statistically significant association was observed between the intervention and the head circumference or length (p = 0.211; 0.597). The weaning rate at the end of follow-up was similar in both groups. Conclusions Breastmilk supplementation may improve the weight gain of very low birthweight preterm infants up to six months corrected gestational age. This effect differed by sex and was considered significant only for males.
References
Stevens TP, Shields E, Campbell D, Combs A, Horgan M, La Gamma EF, et al. Variation in enteral feeding practices and growth outcomes among very premature infants: a report from the New York State Perinatal Quality Collaborative. American journal of perinatology 2016; 2(1): 009-019.
Adamkin DH, Radmacher PG. Fortification of human milk in very low birth weight infants (VLBW< 1500 g birth weight). Clinics in perinatology 2014; 41(2): 405-421.
Lapillonne A, O'connor DL, Wang D, Rigo J. Nutritional recommendations for the late-preterm infant and the preterm infant after hospital discharge. The Journal of Pediatrics 2013; 162(3): S90-S100.
Young L, Morgan J, McCormick FM, McGuire W. Nutrient-enriched formula versus standard term formula for preterm infants following hospital discharge. Cochrane Database Syst Rev 2012; 14(3).
Teller IC, Embleton ND, Griffin IJ, Elburg RM. Post-discharge formula feeding in preterm infants: A systematic review mapping evidence about the role of macronutrient enrichment. Clinical Nutrition 2016; 35(4): 791-801.
Corpeleijn WE, deWaard M, Chirstmann V, Goudoever JB, deWeide MCJ, Kooi EMW, et al. Effect of donor milk on severe infections and mortality in very low-birth-weight infants: the early nutrition study randomized clinical trial. JAMA pediatrics 2016, 170(7): 654-661.
Arslanoglu, S., Boquien, C. Y., King, C., Lamireau, D., Tonetto, P., Barnett, D., ... & Picaud, J. C. Fortification of human milk for preterm infants: update and recommendations of the European Milk Bank Association (EMBA) Working Group on Human Milk Fortification. Frontiers in pediatrics, 2019. 7, 76.
Ziegler EE. Nutritional Needs of the LBW infant. Ann NutrMetab 2011; 58(suppl1):8-18.
Bhatia J. Human Milk and the Premature Infant. Ann NutrMetab 2013; 62(suppl 3):8–14.
Rugolo, LMSS. Crescimento e desenvolvimento a longo prazo do prematuro extremo. Jornal de Pediatria 2005; 81(suppll).
Nzegwu NI, & Ehrenkranz RA. Post-discharge nutrition and the VLBW infant: to supplement or not supplement?: a review of the current evidence. Clinics in perinatology 2014; 41(2): 463-474.
World Health Organization. The Optimal duration of exclusive breastfeeding. Report of an Expert Consultation. Geneva, Switzerland, 28-30 March 2001. Geneva: WHO, 2001; WHO/NHD/01.09, WHO/ FCH/CAH/01.24.
Tsang RC. In: Nutritional needs of the preterm infant. Scientific basis and practical guidelines. New York: Williams and Wilkins, 1993.
Greer RF. Post-discharge nutrition: what does the evidence support? Seminars in Perinatology ISSN 0146-0005 CODEN SEMPDU. Elsevier, Philadelphia, 2007; 31(2): 89-95.
Agostoni C, Buonocore G, Carnielli VP, De Curtis M, Darmaun D, Decsi T, et al. ESPGHAN Committee on Nutrition. Enteral nutrient supply for preterm infants: commentary from the European Society for Pediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2010; 50(1): 85-91.
Camelo Jr. JS, Martinez FE. Dilemas nutricionais no pré-termo extremo e repercussões na infância, adolescência e vida adulta. J Pediatr 2005; 81(1supl): 33-42.
Gonçalves AB, Jorge SM, Gonçalves AL. Comparação entre duas dietas à base de leite humano em relação ao crescimento e à mineralização óssea de recém-nascidos de muito baixo peso. Rev. Paul Pediatr 2009; 27(4): 395-401.
Carver JD, Wu PYK, Hall RT, Ziegler EE, Sosa R, Jacobs J, et al. Growth of preterm infants fed nutrient-enriched or term formula after hospital discharge. Pediatrics 2001; 107(4): 683-689.
O'Connor DL, Khan S, Weishuhn K, Vaughan J, Jefferies A, Campbell DM, et al. Growth and nutrient intakes of human milk-fed preterm infants provided with extra energy and nutrients after hospital discharge. Pediatrics 2008; 121(4): 766–776.
Zachariassen G, Faerk J, Grytter C, Esberg BH, Hjelmborg J, Mortensen S, et al. Nutrient Enrichment of Mother’s Milk and Growth of Very Preterm Infants after Hospital Discharge. Pediatrics 2011; 127(4).
Young L, Embleton ND, McCormick FM, McGuire W, et al. Multinutrient fortification of human breast milk for preterm infants following hospital discharge. Cochrane Database Syst Rev 2013, 4.
Brown, JVE., Lin, L., Embleton, ND., Harding, JE., & McGuire, W. (2020). Multi?nutrient fortification of human milk for preterm nfants. Cochrane Database of Systematic Reviews, (5). Reviews 2020.
Richardson DK, Corcoran JD, Escobar GJ, Lee SK. SNAP-II and SNAPPE-II: simplified newborn illness severity and mortality risk scores. The Journal of pediatrics 2001; 138(1): 92-100.
Fausto MA, Carneiro M, Antunes CM, Pinto JA, Colosimo EA, et al. O modelo de regressão linear misto para dados longitudinais: uma aplicação na análise de dados antropométricos desbalanceados. Cad. Saúde Pública 2008; 24(3): 513-524.
Griffin IJ, Cooke RJ. Nutrition of Preterm Infants after Hospital Discharge. J Pediatr Gastroenterol Nutr 2007; 45(Suppl. 3).
Schulz KF, Altman DG, Moher D, Consort group. Consort 2010 statement: updated guidelines for reporting parallel group randomised trials. British Medical Journal 2010; 23; 340:c332.
Villar J, Giuliani F, Bhutta ZA, Bertino E, Ohuma EO, Ismail LC, et al. Postnatal growth standards for preterm infants: the Preterm Postnatal Follow-up Study of the INTERGROWTH-21st Project. Lancet Glob Health 2015;3:e681–91.
