Breastfeeding, growth, and lung disease in the first 3 years of life in children with cystic fibrosis.

Autor: Lai HJ; Department of Nutritional Sciences, University of Wisconsin College of Agriculture and Life Sciences, Madison, WI, USA; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: hlai@wisc.edu., Bach TR; Department of Nutritional Sciences, University of Wisconsin College of Agriculture and Life Sciences, Madison, WI, USA; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA., Miller T; Clinical Nutrition, Children's Wisconsin, Milwaukee, WI, USA., McDonald CM; Cystic Fibrosis Clinic, Primary Children's Hospital, Salt Lake City, UT, USA., Maguiness KM; Pediatric Pulmonology, Riley Hospital for Children at IU Health, Indianapolis, IN, USA., Seffrood EE; Clinical Nutrition, University of Wisconsin Hospital and Clinics, Madison, WI, USA., Leonard JB; Children's Hospital Boston, Nutrition Center, Boston, MA, USA., Farrell PM; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Jazyk: angličtina
Zdroj: Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [J Cyst Fibros] 2024 Jul 16. Date of Electronic Publication: 2024 Jul 16.
DOI: 10.1016/j.jcf.2024.07.006
Abstrakt: Background: The 2009 cystic fibrosis (CF) infant care guidelines recommend breastmilk as the initial feeding but do not address if/when it should be fortified or supplemented with formula to promote optimal growth and pulmonary health.
Methods: We conducted a prospective multi-center cohort study in breastfed and formula-fed infants that included 172 infants with CF who were born during 2012-17, enrolled after newborn screening at age 1.9 ± 1.0 months, and evaluated growth and lung disease manifestations in the first 3 years of life.
Results: Seventy-two percent of our study cohort was breastfed at birth, but 64 % transitioned to receiving fortified feedings (breastmilk, formula, or a combination) by 6 months of age to reverse the downward trajectory of their growth curves. Fortified feedings accelerated catch-up growth to normal weight-for-age (0.12 ± 0.80 z-score) and near normal height-for-age (-0.13 ± 0.90 z-score) at 3 years of age. Within the fortified group, breastmilk and formula were similarly effective in promoting catch-up growth, but proportionately fewer infants with CF fed predominantly breastmilk (30 %) experienced severe or moderate early-onset lung disease compared to those fed predominantly formula (62 %), p = 0.02.
Conclusions: Most infants with CF require fortified feedings to recuperate from growth faltering and achieve normal growth at 3 years of age. For these infants, the proactive/preventive strategy of fortified breastmilk feedings starting soon after CF diagnosis, an alternative to the reactive/monitoring approach, can minimize the risk of prolonged postnatal growth faltering, accelerate the potential of attaining catch-up growth, and decrease the likelihood of experiencing more severe early-onset lung disease.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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