Individualized Fortification Based on Measured Macronutrient Content of Human Milk Improves Growth and Body Composition in Infants Born Less than 33 Weeks: A Mixed-Cohort Study
The optimal method for human milk (HM) fortification has not yet been determined. This study assessed whether fortification relying on measured HM macronutrient content (Miris AB analyzer, Upsala, Sweden) composition is superior to fortification based on assumed HM macronutrient content, to optimize...
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MDPI AG
2023-03-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/15/6/1533 |
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| author | Manuela Cardoso Daniel Virella Ana Luísa Papoila Marta Alves Israel Macedo Diana e Silva Luís Pereira-da-Silva |
| author_facet | Manuela Cardoso Daniel Virella Ana Luísa Papoila Marta Alves Israel Macedo Diana e Silva Luís Pereira-da-Silva |
| author_sort | Manuela Cardoso |
| collection | DOAJ |
| description | The optimal method for human milk (HM) fortification has not yet been determined. This study assessed whether fortification relying on measured HM macronutrient content (Miris AB analyzer, Upsala, Sweden) composition is superior to fortification based on assumed HM macronutrient content, to optimize the nutrition support, growth, and body composition in infants born at <33 weeks’ gestation. In a mixed-cohort study, 57 infants fed fortified HM based on its measured content were compared with 58 infants fed fortified HM based on its assumed content, for a median of 28 and 23 exposure days, respectively. The ESPGHAN 2010 guidelines for preterm enteral nutrition were followed. Growth assessment was based on body weight, length, and head circumference Δ z-scores, and the respective growth velocities until discharge. Body composition was assessed using air displacement plethysmography. Fortification based on measured HM content provided significantly higher energy, fat, and carbohydrate intakes, although with a lower protein intake in infants weighing ≥ 1 kg and lower protein-to-energy ratio in infants weighing < 1 kg. Infants fed fortified HM based on its measured content were discharged with significantly better weight gain, length, and head growth. These infants had significantly lower adiposity and greater lean mass near term-equivalent age, despite receiving higher in-hospital energy and fat intakes, with a mean fat intake higher than the maximum recommended and a median protein-to-energy ratio intake (in infants weighing < 1 kg) lower than the minimum recommended. |
| first_indexed | 2024-03-11T06:04:22Z |
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| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-11T06:04:22Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-9bf92899aa0f4557aed79aa3e36be79d2023-11-17T13:07:07ZengMDPI AGNutrients2072-66432023-03-01156153310.3390/nu15061533Individualized Fortification Based on Measured Macronutrient Content of Human Milk Improves Growth and Body Composition in Infants Born Less than 33 Weeks: A Mixed-Cohort StudyManuela Cardoso0Daniel Virella1Ana Luísa Papoila2Marta Alves3Israel Macedo4Diana e Silva5Luís Pereira-da-Silva6Nutrition Unit, Maternidade Dr. Alfredo da Costa, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 2890-495 Lisbon, PortugalResearch Unit, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 1169-045 Lisbon, PortugalResearch Unit, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 1169-045 Lisbon, PortugalResearch Unit, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 1169-045 Lisbon, PortugalNeonatal Intensive Care Unit, Maternidade Dr. Alfredo da Costa, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 2890-495 Lisbon, PortugalFaculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, PortugalNeonatal Intensive Care Unit, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 1169-045 Lisbon, PortugalThe optimal method for human milk (HM) fortification has not yet been determined. This study assessed whether fortification relying on measured HM macronutrient content (Miris AB analyzer, Upsala, Sweden) composition is superior to fortification based on assumed HM macronutrient content, to optimize the nutrition support, growth, and body composition in infants born at <33 weeks’ gestation. In a mixed-cohort study, 57 infants fed fortified HM based on its measured content were compared with 58 infants fed fortified HM based on its assumed content, for a median of 28 and 23 exposure days, respectively. The ESPGHAN 2010 guidelines for preterm enteral nutrition were followed. Growth assessment was based on body weight, length, and head circumference Δ z-scores, and the respective growth velocities until discharge. Body composition was assessed using air displacement plethysmography. Fortification based on measured HM content provided significantly higher energy, fat, and carbohydrate intakes, although with a lower protein intake in infants weighing ≥ 1 kg and lower protein-to-energy ratio in infants weighing < 1 kg. Infants fed fortified HM based on its measured content were discharged with significantly better weight gain, length, and head growth. These infants had significantly lower adiposity and greater lean mass near term-equivalent age, despite receiving higher in-hospital energy and fat intakes, with a mean fat intake higher than the maximum recommended and a median protein-to-energy ratio intake (in infants weighing < 1 kg) lower than the minimum recommended.https://www.mdpi.com/2072-6643/15/6/1533adipositybody compositiongrowth velocityhuman milk fortificationpreterm infants |
| spellingShingle | Manuela Cardoso Daniel Virella Ana Luísa Papoila Marta Alves Israel Macedo Diana e Silva Luís Pereira-da-Silva Individualized Fortification Based on Measured Macronutrient Content of Human Milk Improves Growth and Body Composition in Infants Born Less than 33 Weeks: A Mixed-Cohort Study Nutrients adiposity body composition growth velocity human milk fortification preterm infants |
| title | Individualized Fortification Based on Measured Macronutrient Content of Human Milk Improves Growth and Body Composition in Infants Born Less than 33 Weeks: A Mixed-Cohort Study |
| title_full | Individualized Fortification Based on Measured Macronutrient Content of Human Milk Improves Growth and Body Composition in Infants Born Less than 33 Weeks: A Mixed-Cohort Study |
| title_fullStr | Individualized Fortification Based on Measured Macronutrient Content of Human Milk Improves Growth and Body Composition in Infants Born Less than 33 Weeks: A Mixed-Cohort Study |
| title_full_unstemmed | Individualized Fortification Based on Measured Macronutrient Content of Human Milk Improves Growth and Body Composition in Infants Born Less than 33 Weeks: A Mixed-Cohort Study |
| title_short | Individualized Fortification Based on Measured Macronutrient Content of Human Milk Improves Growth and Body Composition in Infants Born Less than 33 Weeks: A Mixed-Cohort Study |
| title_sort | individualized fortification based on measured macronutrient content of human milk improves growth and body composition in infants born less than 33 weeks a mixed cohort study |
| topic | adiposity body composition growth velocity human milk fortification preterm infants |
| url | https://www.mdpi.com/2072-6643/15/6/1533 |
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