The association of human milk intake and outcomes in biliary atresia.

Autor: Tessier MEM; Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Section of Pediatric Gastroenterology Hepatology and Nutrition, Houston, Texas, USA., Schraw JM; Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.; Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA., Beer S; Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Section of Pediatric Gastroenterology Hepatology and Nutrition, Houston, Texas, USA., Harpavat S; Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Section of Pediatric Gastroenterology Hepatology and Nutrition, Houston, Texas, USA., Kyle Jensen M; Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Primary Children's Hospital, University of Utah, Salt Lake City, Utah, USA., Magee JC; Department of Surgery, University of Michigan Hospitals and Health Centers, Ann Arbor, Michigan, USA., Ng V; Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada., Scheurer ME; Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.; Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA., Taylor SA; Department of Pediatrics, Division of Gastroenterology Hepatology and Nutrition, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado, USA., Shneider BL; Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Section of Pediatric Gastroenterology Hepatology and Nutrition, Houston, Texas, USA.
Jazyk: angličtina
Zdroj: Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2024 Nov 11. Date of Electronic Publication: 2024 Nov 11.
DOI: 10.1002/jpn3.12403
Abstrakt: Objectives: Human milk intake has many benefits which could influence outcomes in biliary atresia (BA). However, the role of human milk in BA has not been examined. We hypothesized that human milk intake would be associated with improved outcomes in BA.
Methods: We assessed the impact of any human milk (AHM) as compared to formula only (FO) intake before Kasai portoenterostomy (KP) on outcomes in 447 infants with BA using the PROBE database (NCT00061828) post hoc. The primary outcome was clearance of jaundice (COJ = total bilirubin (TB) < 2 mg/dL by 3 months post-KP). Secondary outcomes included 2-year native liver survival (SNL), bilirubin levels, cholangitis, ascites, and growth. We assessed the fecal microbiome (n = 8) comparing AHM versus FO.
Results: At baseline, 211 infants received AHM and 215 received FO. 53.9% of AHM and 50.5% of FO achieved COJ (p = NS). SNL was insignificantly increased in AHM (odds ratio = 1.47, 95% confidence interval: 1.00-2.12, p = 0.053). TB decreased in AHM from 4 weeks to 3 months post-KP [4.8-4.0 mg/dL (p = 0.01)] unlike the FO group (4.9-4.9 mg/dL, p = 0.4). At 3 months post-KP, AHM infants had greater weight gain (1.88 ± 0.66 vs. 1.57 ± 0.73 kg, p < 0.001) and mid-upper arm circumference (12.9 ± 1.4 vs. 12.2 ± 1.7 cm, p < 0.001). Other secondary outcomes were not different. Microbiome differences were seen between AHM and FO.
Conclusions: Human milk intake in infants with BA did not significantly improve COJ or SNL. However, growth parameters were improved, and TB 3 months post-KP was decreased. Thus, human milk intake should not be discouraged. Prospective studies with detailed assessment of human milk intake are needed.
(© 2024 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
Databáze: MEDLINE
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