Human Milk Fortification in Very Preterm Infants in China: A Multicenter Survey
AimTo investigate the use of human milk fortifier (HMF) for very preterm infants (VPIs) and complications and nutritional status of VPIs due to various breast milk enhancement strategies among the Chinese population.MethodsVPIs with birth weight < 1,800 g and wholly or predominantly breastfed...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-02-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.795222/full |
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| author | Rong Lin Rong Lin Wei Shen Wei Shen Fan Wu Jian Mao Ling Liu Yanmei Chang Rong Zhang Xiuzhen Ye Yinping Qiu Li Ma Rui Cheng Hui Wu Dongmei Chen Zhi Zheng Zhi Zheng Xinzhu Lin Xinzhu Lin Xiaomei Tong the National Multicenter EUGR Collaborative Group |
| author_facet | Rong Lin Rong Lin Wei Shen Wei Shen Fan Wu Jian Mao Ling Liu Yanmei Chang Rong Zhang Xiuzhen Ye Yinping Qiu Li Ma Rui Cheng Hui Wu Dongmei Chen Zhi Zheng Zhi Zheng Xinzhu Lin Xinzhu Lin Xiaomei Tong the National Multicenter EUGR Collaborative Group |
| author_sort | Rong Lin |
| collection | DOAJ |
| description | AimTo investigate the use of human milk fortifier (HMF) for very preterm infants (VPIs) and complications and nutritional status of VPIs due to various breast milk enhancement strategies among the Chinese population.MethodsVPIs with birth weight < 1,800 g and wholly or predominantly breastfed were assigned to the following fortification groups: no HMF, early HMF (adding HMF at an enteral volume of ≤ 80 ml·kg−1·day−1), middle HMF (adding HMF at an enteral volume of 80–100 ml·kg−1·day−1), and late HMF (adding HMF at an enteral volume of ≥100 ml·kg−1·day−1). The growth status and complications for various groups were evaluated.ResultsWe enrolled 985 VPIs, of which 847 VPIs (86.0%) received HMF, whereas 138 VPIs (14.0%) did not. The number of VPIs in the early, middle, and late fortification groups were 89 (9.0%), 252 (25.6%), and 506 (51.4%), respectively. The complete fortification of the early, middle, and late fortification groups was achieved in 13.2 ± 11.0, 13.8 ± 11.7, and 12.3 ± 13.0 days, respectively, without significant differences (p > 0.05). The groups did not exhibit significant differences in the incidence of feeding intolerance, necrotizing enterocolitis (Bell stage ≥ 2), late-onset sepsis, and metabolic bone diseases (p > 0.05). The middle fortification groups exhibited the fastest growth velocity and the least dramatic decrease in the Z-score of weight and length, and the lowest incidence of EUGR (35.7%), whereas the “no HMF” groups exhibited the slowest growth velocity and the largest decline in the Z-score, and the highest incidence of EUGR (61.6%).ConclusionsThe usage rate of HMF was relatively low among Chinese VPIs, fortification often occurred in the late feeding stage, and the time to reach complete fortification was long. Adding HMF and different breast milk enhancement strategies did not increase the incidence of feeding intolerance and necrotizing enterocolitis. The enteral volume of 80–100 ml·kg−1·day−1 with HMF addition led to increased growth in the weight and length and lower EUGR incidence, indicating that the addition of HMF at the specific feeding volume might be the best practice for promoting growth. |
| first_indexed | 2024-12-13T12:54:01Z |
| format | Article |
| id | doaj.art-46e28dff868c42e096156cb59caf8928 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-13T12:54:01Z |
| publishDate | 2022-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-46e28dff868c42e096156cb59caf89282022-12-21T23:45:14ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-02-011010.3389/fped.2022.795222795222Human Milk Fortification in Very Preterm Infants in China: A Multicenter SurveyRong Lin0Rong Lin1Wei Shen2Wei Shen3Fan Wu4Jian Mao5Ling Liu6Yanmei Chang7Rong Zhang8Xiuzhen Ye9Yinping Qiu10Li Ma11Rui Cheng12Hui Wu13Dongmei Chen14Zhi Zheng15Zhi Zheng16Xinzhu Lin17Xinzhu Lin18Xiaomei Tong19the National Multicenter EUGR Collaborative GroupDepartment of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, ChinaXiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, ChinaDepartment of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, ChinaXiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, ChinaDepartment of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Neonatology, Guiyang Maternal and Child Health Hospital Guiyang Children's Hospital, Guiyang, ChinaDepartment of Pediatrics, Peking University Third Hospital, Beijing, ChinaDepartment of Neonatology, Pediatric Hospital of Fudan University, Shanghai, ChinaDepartment of Neonatology, Guangdong Province Maternal and Children's Hospital, Guangzhou, ChinaDepartment of Neonatology, General Hospital of Ningxia Medical University, Yinchuan, China0Department of Neonatology, Children's Hospital of Hebei Province, Shijiazhuang, China1Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing, China2Department of Neonatology, The First Hospital of Jilin University, Changchun, China3Department of Neonatology, Quanzhou Maternity and Children's Hospital, Quanzhou, ChinaDepartment of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, ChinaXiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, ChinaDepartment of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, ChinaXiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, ChinaDepartment of Pediatrics, Peking University Third Hospital, Beijing, ChinaAimTo investigate the use of human milk fortifier (HMF) for very preterm infants (VPIs) and complications and nutritional status of VPIs due to various breast milk enhancement strategies among the Chinese population.MethodsVPIs with birth weight < 1,800 g and wholly or predominantly breastfed were assigned to the following fortification groups: no HMF, early HMF (adding HMF at an enteral volume of ≤ 80 ml·kg−1·day−1), middle HMF (adding HMF at an enteral volume of 80–100 ml·kg−1·day−1), and late HMF (adding HMF at an enteral volume of ≥100 ml·kg−1·day−1). The growth status and complications for various groups were evaluated.ResultsWe enrolled 985 VPIs, of which 847 VPIs (86.0%) received HMF, whereas 138 VPIs (14.0%) did not. The number of VPIs in the early, middle, and late fortification groups were 89 (9.0%), 252 (25.6%), and 506 (51.4%), respectively. The complete fortification of the early, middle, and late fortification groups was achieved in 13.2 ± 11.0, 13.8 ± 11.7, and 12.3 ± 13.0 days, respectively, without significant differences (p > 0.05). The groups did not exhibit significant differences in the incidence of feeding intolerance, necrotizing enterocolitis (Bell stage ≥ 2), late-onset sepsis, and metabolic bone diseases (p > 0.05). The middle fortification groups exhibited the fastest growth velocity and the least dramatic decrease in the Z-score of weight and length, and the lowest incidence of EUGR (35.7%), whereas the “no HMF” groups exhibited the slowest growth velocity and the largest decline in the Z-score, and the highest incidence of EUGR (61.6%).ConclusionsThe usage rate of HMF was relatively low among Chinese VPIs, fortification often occurred in the late feeding stage, and the time to reach complete fortification was long. Adding HMF and different breast milk enhancement strategies did not increase the incidence of feeding intolerance and necrotizing enterocolitis. The enteral volume of 80–100 ml·kg−1·day−1 with HMF addition led to increased growth in the weight and length and lower EUGR incidence, indicating that the addition of HMF at the specific feeding volume might be the best practice for promoting growth.https://www.frontiersin.org/articles/10.3389/fped.2022.795222/fullhuman milk fortifiervery preterm infantsextrauterine growth restrictionfeeding intolerancehuman milk |
| spellingShingle | Rong Lin Rong Lin Wei Shen Wei Shen Fan Wu Jian Mao Ling Liu Yanmei Chang Rong Zhang Xiuzhen Ye Yinping Qiu Li Ma Rui Cheng Hui Wu Dongmei Chen Zhi Zheng Zhi Zheng Xinzhu Lin Xinzhu Lin Xiaomei Tong the National Multicenter EUGR Collaborative Group Human Milk Fortification in Very Preterm Infants in China: A Multicenter Survey Frontiers in Pediatrics human milk fortifier very preterm infants extrauterine growth restriction feeding intolerance human milk |
| title | Human Milk Fortification in Very Preterm Infants in China: A Multicenter Survey |
| title_full | Human Milk Fortification in Very Preterm Infants in China: A Multicenter Survey |
| title_fullStr | Human Milk Fortification in Very Preterm Infants in China: A Multicenter Survey |
| title_full_unstemmed | Human Milk Fortification in Very Preterm Infants in China: A Multicenter Survey |
| title_short | Human Milk Fortification in Very Preterm Infants in China: A Multicenter Survey |
| title_sort | human milk fortification in very preterm infants in china a multicenter survey |
| topic | human milk fortifier very preterm infants extrauterine growth restriction feeding intolerance human milk |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.795222/full |
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