Donor milk intake and infant growth in a South African neonatal unit: a cohort study.

Autor: Sparks H; 1Northwestern University Feinberg School of Medicine, Chicago, IL USA., Linley L; 2Division of Neonatology, School of Child and Adolescent Health, University of Cape Town and Mowbray Maternity Hospital, Cape Town, South Africa., Beaumont JL; 3Terasaki Research Institute, Los Angeles, CA USA.; 4Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA., Robinson DT; 5Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL USA.; 6Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL USA.
Jazyk: angličtina
Zdroj: International breastfeeding journal [Int Breastfeed J] 2018 Sep 04; Vol. 13, pp. 41. Date of Electronic Publication: 2018 Sep 04 (Print Publication: 2018).
DOI: 10.1186/s13006-018-0183-8
Abstrakt: Background: Implications of donor milk feedings on infant growth in resource limited settings remain uncertain. This knowledge gap includes the impact of donor milk availability on infant intake of mother's own milk. Therefore, this investigation aimed to measure intake and growth in infants receiving donor milk when born to women from resource limited backgrounds with high rates of human immunodeficiency virus (HIV).
Methods: A retrospective cohort study enrolled eligible infants admitted to a South African combined neonatal intensive and secondary high care unit, within a one year admission period during 2015, with signed consent for donor milk feedings. A certified milk bank provided donor milk. Daily nutritional intake during the first month was recorded. Details included proportional intake of donor milk, mother's own milk and infant formula. The primary outcome of infant growth velocity from day back to birth weight to discharge was calculated when length of stay was ≥14 days. Analyses primarily used T-tests; mixed effects models compared weekly calorie intake.
Results: One hundred five infants with donor milk consent were born at 30.9 ± 3.6 weeks of gestation, weighing 1389 ± 708 g. Forty percent of mothers had HIV. Infant growth velocity did not differ based on percent of feedings as donor milk (≥ 50%: 11.8 ± 4.9 g/kg/d; < 50%: 13.5 ± 5.3 g/kg/d; p  = 0.3). Percent of feedings from donor milk was similar based on maternal HIV status (positive: 31 ± 25%; negative: 36 ± 29%; p  = 0.4), as was percent of feedings as mother's milk (positive: 53 ± 35%; negative: 58 ± 30%; p  = 0.4). Calorie intake increased markedly during the first two weeks and then plateaued ( p  < 0.0001).
Conclusions: Donor milk feedings in higher proportions did not further impair growth of infants managed in a South African combined neonatal intensive and secondary high care unit with growth rates already below reference ranges. The provision of donor milk contributed to feedings being composed of primarily human milk during the first month. Increasing early calorie intake may improve infant growth in this center.
Competing Interests: The Human Research Ethics Committees for the University of Cape Town and Mowbray Maternity Hospital approved this human subject research (#236/2016). A waiver of consent was provided for this retrospective study.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Databáze: MEDLINE
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