Early versus Delayed Human Milk Fortification in Very Low Birth Weight Infants–A Randomized Controlled Trial - 24/06/16
, Narendra Dereddy, MD 2, Tamekia L. Jones, PhD 2, 3, Ramasubbareddy Dhanireddy, MD 2, 4, Ajay J. Talati, MD 2, 4Abstract |
Objective |
To compare the effect of initiating human milk fortification at 2 different feeding volumes on feeding intolerance and the time to reach full feeding volume.
Study design |
Very low birth weight infants (n = 100) were prospectively randomized to early fortification (EF) (beginning at a feeding volume of 20 mL/kg/d) or delayed fortification (at a feeding volume of 100 mL/kg/d). We employed a standardized feeding protocol and parenteral nutrition guidelines for the nutritional management of all study infants.
Results |
The median days to reach full feeding volumes were equivalent in the 2 groups (20 vs 20, P = .45). No significant difference was observed in the total number of episodes of feeding intolerance (58 vs 57). Two cases of necrotizing enterocolitis (Bell stage ≥2) and deaths occurred in each group. Median daily protein intake (g/kg/d) was higher in EF group in week 1 (3.3 [3.2, 3.5] vs 3.1 [2.9, 3.3], P < .001), week 2 (3.6 [3.5, 3.8] vs 3.2 [2.9, 3.4], P < .001), and week 3 (3.7 [3.4, 3.9] vs 3.5 [2.8, 3.8], P = .006). Cumulative protein intake (g/kg) in the first 4 weeks of life was higher in EF group (98.6 [93.8, 104] vs 89.6 [84.2, 96.4], P < .001).
Conclusions |
Very early human milk fortification may improve early protein intake in very low birth weight infants without increasing frequencies of adverse events.
Trial registration |
ClinicalTrials.gov: NCT01988792.
Le texte complet de cet article est disponible en PDF.Keywords : protein intake, growth, caloric intake
Abbreviations : BW, DBM, DF, DOL, EF, HMF, NEC, VLBW
Plan
| Supported by funding from Mead Johnson Nutrition, which had no role in study design, data collection, or data analysis; and University of Tennessee Health Science Center (R07-3223-563) for support research nurse and administrative expenses. S.S. received travel funds from Mead Johnson Nutrition to present some of the data at the Pediatric Academic Societies Annual Meeting. The other authors declare no conflicts of interest. |
Vol 174
P. 126 - juillet 2016 Retour au numéro
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