Donor breast milk feeding may slow down in-hospital weight gain in preemies
Feeding with donor breast milk (DBM) may compromise early in-hospital weight gain and potentially lead to early cognitive delays in preterm infants as compared with mother’s own milk (MOM) or preterm formula (PF), a study suggests.
The single-centre, observational cohort study included 81 preterm infants at a level 3 neonatal intensive care unit (mean gestational age 27.1 weeks; mean birthweight, 914 g). Of these, 27 were supplemented with DBM predominantly (>50 percent), 25 with PF, and 29 with MOM. None of the infants had major congenital defects, death prior to discharge from the hospital, or supplementation volumes of <50 percent over the first month of life.
In-hospital weight gain was evaluated as the primary outcome, while neurodevelopment (as assessed by the Bayley III scale at 1 and 2 years’ corrected age) was the secondary outcome. The outcomes were compared among the three feeding groups using the χ2 test, ANOVA and ANCOVA, with posthoc pairwise comparisons after adjustment for the following confounders: bronchopulmonary dysplasia, multiple births and social work involvement.
The DBM and PF groups were similar in terms of socioeconomic characteristics. Birthweight gain over the first month of life occurred more slowly in the DBM group than in the MOM and PF groups (mean, 17.9 vs 22.0 and 20.3 g/kg/d, respectively; p=0.05). However, this difference in growth decreased at later time points.
Compared with those who received non-DBM diets, infants fed DBM had significantly lower cognition scores both at age 1 year (p=0.005) and 2 years (p=0.03).
The present data highlight the need for further research on the optimal use of DBM in the preterm population, as well as reinforce a continued need for promoting breastfeeding efforts to supply MOM.
Accepted worldwide as the optimal exclusive first source of nutrition, breastmilk is the normal way to feed infants. A mother’s milk contains bioactive molecules that promote gastrointestinal development and reduce the risk of infection, and feeding with MOM is associated with reduced risk of necrotizing enterocolitis, sepsis, and hospital readmission and improved neurodevelopment among very low-birth-weight infants (VLBW; <1500 g). [Pediatrics 2012;129:e827–e841; JAMA 2016;316:1897–1905]
While majority of mothers intend to breastfeed, many mothers of sick, hospitalized newborns, particularly those of VLBW, cannot provide a full volume of milk due to numerous physical and emotional barriers to breastfeeding. In such cases, it is said that infants may benefit most from receiving breast milk nutrition, with pasteurized donor milk being the first consideration for supplementation when there is an inadequate supply of MOM. [Int Breastfeed J 2014;9:4]