Growth outcomes of small for gestational age preterm infants before and after implementation of an exclusive human milk-based diet

Lindsay Fleig; Joseph Hagan; Martin L Lee; Steven A Abrams; Keli M Hawthorne; Amy B Hair

doi:10.1038/s41372-021-01082-x

Growth outcomes of small for gestational age preterm infants before and after implementation of an exclusive human milk-based diet

J Perinatol. 2021 Aug;41(8):1859-1864. doi: 10.1038/s41372-021-01082-x. Epub 2021 May 19.

Authors

Lindsay Fleig^{1

2}, Joseph Hagan³, Martin L Lee^{4

5}, Steven A Abrams⁶, Keli M Hawthorne⁶, Amy B Hair⁷

Affiliations

¹ Department of Pediatrics, Division of Neonatology, University of Texas at Houston Health Science Center, Children's Memorial Hermann Hospital, Houston, TX, USA. lindsay.n.fleig@uth.tmc.edu.
² Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. lindsay.n.fleig@uth.tmc.edu.
³ Department of Pediatrics, Division of Neonatology, University of Texas at Houston Health Science Center, Children's Memorial Hermann Hospital, Houston, TX, USA.
⁴ Prolacta Bioscience, Duarte, CA, USA.
⁵ Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
⁶ Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
⁷ Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Abstract

Objective: Small for gestational age (SGA) preterm infants (PT) are at greatest risk for growth failure. Our objective was to assess the impact of an exclusive human milk diet (HUM) on growth velocities and neonatal morbidities from birth to discharge in a SGA population.

Study design: Multicenter, retrospective cohort study, subgroup analysis of SGA PT comparing a cow's milk diet (CMD) with HUM diet.

Results: At birth 420 PT were classified as SGA (197 CMD group, 223 HUM group). Demographics and anthropometric measurements were similar. HUM group PT showed improvement in length Z score at discharge (p = 0.024) and reduction in necrotizing enterocolitis (NEC) (p = 0.004).

Conclusion: SGA PT fed a HUM diet had significantly decreased incidence of NEC, surgical NEC, and late-onset sepsis. Due to concerns about growth in a HUM diet, it is reassuring SGA infants fed the HUM diet had similar growth to CMD diet with trends toward improvement.

Publication types

Multicenter Study

MeSH terms

Animals
Cattle
Diet
Enterocolitis, Necrotizing* / epidemiology
Enterocolitis, Necrotizing* / prevention & control
Female
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Milk, Human*
Retrospective Studies

Grants and funding

UL1 TR003167/TR/NCATS NIH HHS/United States