TY - JOUR
T1 - Tolerance of Hydrolyzed Liquid Protein Fortified Human Milk and Effect on Growth in Premature Infants
AU - Shakeel, Fauzia
AU - Newkirk, Melanie
AU - Altoubah, Taymeyah
AU - Martinez, Denise
AU - Amankwah, Ernest K.
N1 - Funding Information:
Conflict of interest and source of funding: This research was partially funded by Abbott Nutrition (Abbott laboratories Inc.) which included supply of study product with extensively hydrolyzed liquid protein fortifier for human milk and compensation for research assistant for data collection. Grant # 6550086032.
Publisher Copyright:
© 2018 American Society for Parenteral and Enteral Nutrition
PY - 2019/6
Y1 - 2019/6
N2 - Background: We evaluated tolerance of hydrolyzed liquid protein (LP) supplement added to fortified human milk (HM) to optimize protein intake in preterm infants. Methods: A prospective observational study of 31 subjects compared with 31 historic controls, receiving mothers own milk (MOM) and/or donor milk (DM) to assess LP tolerance, growth, and risk for morbidities was conducted. Milk was analyzed for nutrient content. Feeding intolerance, defined as cessation of feedings for ≥48 hours, abdominal distension and/or residuals, necrotizing enterocolitis (NEC), and metabolic acidosis were used to assess safety, while weight and head circumference (HC) were used to evaluate growth. Results: LP added to powder-fortified HM had no impact on feeding intolerance and NEC. Biochemical parameters showed no metabolic acidosis: blood urea nitrogen levels (first week: median, 13 mg/dL; interquartile range [IQR], 9–16; last week: median, 13 mg/dL; IQR, 10.3–14; P =.94), bicarbonate levels (first week: median, 26.3 mEq/L; IQR, 24–28; last week: median, 28 mEq/L; IQR, 26.3–29.8; P =.10), and pH levels (first week: median, 7.4; IQR, 7.3–7.4; last week: median, 7.4; IQR, 7.37–7.40; P =.5). Weight and HC were not statistically significant. HM analysis showed lower protein and caloric content, respectively (MOM: 0.88 vs DM: 0.77 g/100 mL; P <.0001 and MOM: 18.68 vs DM: 17.96 kcal/oz; P =.02). Conclusions: Hydrolyzed LP is well tolerated in preterm infants with no difference in growth rates. Clinicians should focus on the need to maximize both protein and energy to optimize growth.
AB - Background: We evaluated tolerance of hydrolyzed liquid protein (LP) supplement added to fortified human milk (HM) to optimize protein intake in preterm infants. Methods: A prospective observational study of 31 subjects compared with 31 historic controls, receiving mothers own milk (MOM) and/or donor milk (DM) to assess LP tolerance, growth, and risk for morbidities was conducted. Milk was analyzed for nutrient content. Feeding intolerance, defined as cessation of feedings for ≥48 hours, abdominal distension and/or residuals, necrotizing enterocolitis (NEC), and metabolic acidosis were used to assess safety, while weight and head circumference (HC) were used to evaluate growth. Results: LP added to powder-fortified HM had no impact on feeding intolerance and NEC. Biochemical parameters showed no metabolic acidosis: blood urea nitrogen levels (first week: median, 13 mg/dL; interquartile range [IQR], 9–16; last week: median, 13 mg/dL; IQR, 10.3–14; P =.94), bicarbonate levels (first week: median, 26.3 mEq/L; IQR, 24–28; last week: median, 28 mEq/L; IQR, 26.3–29.8; P =.10), and pH levels (first week: median, 7.4; IQR, 7.3–7.4; last week: median, 7.4; IQR, 7.37–7.40; P =.5). Weight and HC were not statistically significant. HM analysis showed lower protein and caloric content, respectively (MOM: 0.88 vs DM: 0.77 g/100 mL; P <.0001 and MOM: 18.68 vs DM: 17.96 kcal/oz; P =.02). Conclusions: Hydrolyzed LP is well tolerated in preterm infants with no difference in growth rates. Clinicians should focus on the need to maximize both protein and energy to optimize growth.
KW - enteral nutrition
KW - human milk
KW - infant
KW - protein supplement
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U2 - 10.1002/ncp.10193
DO - 10.1002/ncp.10193
M3 - Article
C2 - 30320413
AN - SCOPUS:85055017447
SN - 0884-5336
VL - 34
SP - 450
EP - 458
JO - Nutrition in Clinical Practice
JF - Nutrition in Clinical Practice
IS - 3
ER -