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Research Project: Pediatric Clinical Nutrition

Location: Children's Nutrition Research Center

Title: Greater mortality and mordidity in extremely preterm infants fed a diet containing cow milk protein products

item ABRAMS, STEVEN - Children'S Nutrition Research Center (CNRC)
item SCHANLER, RICHARD - Cohen Children'S Medical Center Of New York
item LEE, MARTIN - Prolacta Bioscience
item RECHTMAN, DAVID - Prolacta Bioscience

Submitted to: Breastfeeding Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/27/2014
Publication Date: 6/6/2014
Citation: Abrams, S.A., Schanler, R.J., Lee, M.L., Rechtman, D.J., and the Prolacta Study Group 2014. Greater mortality and mordidity in extremely preterm infants fed a diet containing cow milk protein products. Breastfeeding Medicine. 9(6):281-285.

Interpretive Summary: Giving premature babies human milk improves how they do in life. In this study we looked at whether giving only human milk to very small premature infants helped them avoid serious diseases of dying. We found that this was the case with the more human milk being given, the less intestinal diseases and infections that occurred in the babies. Babies who got more human milk also had less time needing intravenous nutrition which is important as this is expensive and can be dangerous to their health. We concluded that consideration should be given to only giving very small premature babies a diet of human milk in the first months of life.

Technical Abstract: Provision of human milk has important implications for the health and outcomes of extremely preterm (EP) infants. This study evaluated the effects of an exclusive human milk diet on the health of EP infants during their stay in the neonatal intensive care unit. EP infants <1,250 g birth weight received a diet consisting of either human milk fortified with a human milk protein-based fortifier (HM) (n = 167) or a diet containing variable amounts of milk containing cow milk-based protein (CM) (n = 93). Principal outcomes were mortality, necrotizing enterocolitis (NEC), growth, and duration of parenteral nutrition (PN). Mortality (2% versus 8%, p = 0.004) and NEC (5% versus 17%, p = 0.002) differed significantly between the HM and CM groups, respectively. For every 10% increase in the volume of milk containing CM, the risk of sepsis increased by 17.9% ( p < 0.001). Growth rates were similar between groups. The duration of PN was 8 days less in the subgroup of infants receiving a diet containing <10% CM versus +/-10% CM ( p < 0.02). An exclusive human milk diet, devoid of CM-containing products, was associated with lower mortality and morbidity in EP infants without compromising growth and should be considered as an approach to nutritional care of these infants.