Early versus Delayed Human Milk Fortification in Very Low Birth Weight Infants-A Randomized Controlled Trial

Sanket D. Shah, Narendra Dereddy, Tamekia Jones, Ramasubbareddy Dhanireddy, Ajay Talati

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)126-131.e1
JournalJournal of Pediatrics
Volume174
DOIs
StatePublished - Jul 1 2016

Fingerprint

Very Low Birth Weight Infant
Human Milk
Randomized Controlled Trials
Nutrition Policy
Necrotizing Enterocolitis
Proteins
Parenteral Nutrition

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Early versus Delayed Human Milk Fortification in Very Low Birth Weight Infants-A Randomized Controlled Trial. / Shah, Sanket D.; Dereddy, Narendra; Jones, Tamekia; Dhanireddy, Ramasubbareddy; Talati, Ajay.

In: Journal of Pediatrics, Vol. 174, 01.07.2016, p. 126-131.e1.

Research output: Contribution to journalArticle

@article{b3c53861c118499ab96104fb3c6a8992,
title = "Early versus Delayed Human Milk Fortification in Very Low Birth Weight Infants-A Randomized Controlled Trial",
abstract = "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.",
author = "Shah, {Sanket D.} and Narendra Dereddy and Tamekia Jones and Ramasubbareddy Dhanireddy and Ajay Talati",
year = "2016",
month = "7",
day = "1",
doi = "10.1016/j.jpeds.2016.03.056",
language = "English (US)",
volume = "174",
pages = "126--131.e1",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Early versus Delayed Human Milk Fortification in Very Low Birth Weight Infants-A Randomized Controlled Trial

AU - Shah, Sanket D.

AU - Dereddy, Narendra

AU - Jones, Tamekia

AU - Dhanireddy, Ramasubbareddy

AU - Talati, Ajay

PY - 2016/7/1

Y1 - 2016/7/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84966600260&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84966600260&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2016.03.056

DO - 10.1016/j.jpeds.2016.03.056

M3 - Article

VL - 174

SP - 126-131.e1

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

ER -