Associations of Macronutrient Intake Determined by Point-of-Care Human Milk Analysis with Brain Development among very Preterm Infants
Point-of-care human milk analysis is now feasible in the neonatal intensive care unit (NICU) and allows accurate measurement of macronutrient delivery. Higher macronutrient intakes over this period may promote brain growth and development. In a prospective, observational study of 55 infants born at...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-06-01
|
| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/9/7/969 |
| _version_ | 1827619091178848256 |
|---|---|
| author | Katherine A. Bell Sara Cherkerzian Kaitlin Drouin Lillian G. Matthews Terrie E. Inder Anna K. Prohl Simon K. Warfield Mandy Brown Belfort |
| author_facet | Katherine A. Bell Sara Cherkerzian Kaitlin Drouin Lillian G. Matthews Terrie E. Inder Anna K. Prohl Simon K. Warfield Mandy Brown Belfort |
| author_sort | Katherine A. Bell |
| collection | DOAJ |
| description | Point-of-care human milk analysis is now feasible in the neonatal intensive care unit (NICU) and allows accurate measurement of macronutrient delivery. Higher macronutrient intakes over this period may promote brain growth and development. In a prospective, observational study of 55 infants born at <32 weeks’ gestation, we used a mid-infrared spectroscopy-based human milk analyzer to measure the macronutrient content in repeated samples of human milk over the NICU hospitalization. We calculated daily nutrient intakes from unfortified milk and assigned infants to quintiles based on median intakes over the hospitalization. Infants underwent brain magnetic resonance imaging at term equivalent age to quantify total and regional brain volumes and fractional anisotropy of white matter tracts. Infants in the highest quintile of energy intake from milk, as compared with the lower four quintiles, had larger total brain volume (31 cc, 95% confidence interval [CI]: 5, 56), cortical gray matter (15 cc, 95%CI: 1, 30), and white matter volume (23 cc, 95%CI: 12, 33). Higher protein intake was associated with larger total brain (36 cc, 95%CI: 7, 65), cortical gray matter (22 cc, 95%CI: 6, 38) and deep gray matter (1 cc, 95%CI: 0.1, 3) volumes. These findings suggest innovative strategies to close nutrient delivery gaps in the NICU may promote brain growth for preterm infants. |
| first_indexed | 2024-03-09T10:21:21Z |
| format | Article |
| id | doaj.art-8bf35a1ca4a44c4f8755d3989e2329f5 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T10:21:21Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-8bf35a1ca4a44c4f8755d3989e2329f52023-12-01T22:01:29ZengMDPI AGChildren2227-90672022-06-019796910.3390/children9070969Associations of Macronutrient Intake Determined by Point-of-Care Human Milk Analysis with Brain Development among very Preterm InfantsKatherine A. Bell0Sara Cherkerzian1Kaitlin Drouin2Lillian G. Matthews3Terrie E. Inder4Anna K. Prohl5Simon K. Warfield6Mandy Brown Belfort7Department of Pediatric Newborn Medicine, Brigham & Women’s Hospital, Boston, MA 02115, USADepartment of Pediatric Newborn Medicine, Brigham & Women’s Hospital, Boston, MA 02115, USADepartment of Pediatric Newborn Medicine, Brigham & Women’s Hospital, Boston, MA 02115, USADepartment of Pediatric Newborn Medicine, Brigham & Women’s Hospital, Boston, MA 02115, USADepartment of Pediatric Newborn Medicine, Brigham & Women’s Hospital, Boston, MA 02115, USAHarvard Medical School, Boston, MA 02115, USAHarvard Medical School, Boston, MA 02115, USADepartment of Pediatric Newborn Medicine, Brigham & Women’s Hospital, Boston, MA 02115, USAPoint-of-care human milk analysis is now feasible in the neonatal intensive care unit (NICU) and allows accurate measurement of macronutrient delivery. Higher macronutrient intakes over this period may promote brain growth and development. In a prospective, observational study of 55 infants born at <32 weeks’ gestation, we used a mid-infrared spectroscopy-based human milk analyzer to measure the macronutrient content in repeated samples of human milk over the NICU hospitalization. We calculated daily nutrient intakes from unfortified milk and assigned infants to quintiles based on median intakes over the hospitalization. Infants underwent brain magnetic resonance imaging at term equivalent age to quantify total and regional brain volumes and fractional anisotropy of white matter tracts. Infants in the highest quintile of energy intake from milk, as compared with the lower four quintiles, had larger total brain volume (31 cc, 95% confidence interval [CI]: 5, 56), cortical gray matter (15 cc, 95%CI: 1, 30), and white matter volume (23 cc, 95%CI: 12, 33). Higher protein intake was associated with larger total brain (36 cc, 95%CI: 7, 65), cortical gray matter (22 cc, 95%CI: 6, 38) and deep gray matter (1 cc, 95%CI: 0.1, 3) volumes. These findings suggest innovative strategies to close nutrient delivery gaps in the NICU may promote brain growth for preterm infants.https://www.mdpi.com/2227-9067/9/7/969human milk analysispreterm infantmacronutrientbrain volumesdiffusion tensor imaging |
| spellingShingle | Katherine A. Bell Sara Cherkerzian Kaitlin Drouin Lillian G. Matthews Terrie E. Inder Anna K. Prohl Simon K. Warfield Mandy Brown Belfort Associations of Macronutrient Intake Determined by Point-of-Care Human Milk Analysis with Brain Development among very Preterm Infants Children human milk analysis preterm infant macronutrient brain volumes diffusion tensor imaging |
| title | Associations of Macronutrient Intake Determined by Point-of-Care Human Milk Analysis with Brain Development among very Preterm Infants |
| title_full | Associations of Macronutrient Intake Determined by Point-of-Care Human Milk Analysis with Brain Development among very Preterm Infants |
| title_fullStr | Associations of Macronutrient Intake Determined by Point-of-Care Human Milk Analysis with Brain Development among very Preterm Infants |
| title_full_unstemmed | Associations of Macronutrient Intake Determined by Point-of-Care Human Milk Analysis with Brain Development among very Preterm Infants |
| title_short | Associations of Macronutrient Intake Determined by Point-of-Care Human Milk Analysis with Brain Development among very Preterm Infants |
| title_sort | associations of macronutrient intake determined by point of care human milk analysis with brain development among very preterm infants |
| topic | human milk analysis preterm infant macronutrient brain volumes diffusion tensor imaging |
| url | https://www.mdpi.com/2227-9067/9/7/969 |
| work_keys_str_mv | AT katherineabell associationsofmacronutrientintakedeterminedbypointofcarehumanmilkanalysiswithbraindevelopmentamongverypreterminfants AT saracherkerzian associationsofmacronutrientintakedeterminedbypointofcarehumanmilkanalysiswithbraindevelopmentamongverypreterminfants AT kaitlindrouin associationsofmacronutrientintakedeterminedbypointofcarehumanmilkanalysiswithbraindevelopmentamongverypreterminfants AT lilliangmatthews associationsofmacronutrientintakedeterminedbypointofcarehumanmilkanalysiswithbraindevelopmentamongverypreterminfants AT terrieeinder associationsofmacronutrientintakedeterminedbypointofcarehumanmilkanalysiswithbraindevelopmentamongverypreterminfants AT annakprohl associationsofmacronutrientintakedeterminedbypointofcarehumanmilkanalysiswithbraindevelopmentamongverypreterminfants AT simonkwarfield associationsofmacronutrientintakedeterminedbypointofcarehumanmilkanalysiswithbraindevelopmentamongverypreterminfants AT mandybrownbelfort associationsofmacronutrientintakedeterminedbypointofcarehumanmilkanalysiswithbraindevelopmentamongverypreterminfants |