HUMAN MILK FAT IMPROVES GROWTH IN PREMATURE INFANTS
For premature infants,
adequate growth while in the neonatal intensive care unit is an indicator of
better long-term health and developmental outcomes. Researchers at the USDA/ARS
Children's Nutrition Research Center at Baylor College of Medicine and Texas
Children's Hospital have now successfully incorporated a cream supplement into
premature infants' diets that improved their growth outcomes in the NICU. The
report appears in the Journal of Pediatrics
For
premature babies who weigh less than 1,000 grams (about 2 pounds, 2 ounces),
one of the problems is that their lungs and other organs are still developing
when they are born. If the infant gains weight and increases in length at a
good rate while in the NICU, this helps improve their outcomes," said Dr.
Amy Hair, assistant professor of pediatrics at Baylor, neonatologist at Texas
Children's Hospital and first author of the study.
Previous
research has shown that an exclusive human milk diet protects the intestines of
premature infants and supports their growth. This diet consists of mothers' own
breast milk or donor human milk, as well as a fortifier consisting of protein
and minerals made from the donor milk.
In
this study, researchers sought a way to optimize this growth in very small
infants (those who weigh between 750 and 1,250 grams) who need additional
calories. Because infants are already receiving enough protein from the
fortifier, another way to help them grow is by giving them fat. One of the
byproducts of pasteurizing donor milk is milk fat, also referred to as a cream
supplement.
In
this study, researchers compared the growth outcomes of infants who received
the exclusive human milk diet and the cream supplement to infants who received
just the exclusive human milk diet. They found that infants in the cream group
had better growth outcomes in terms of weight and length than infants in the
control group.
"This
is a natural way to give them fat. Previously, we would add oils or infant
formula to help premature babies grow, but we can now use a natural source from
donor milk," said Hair.
Hair
noted that because the growth was both in weight and length, this growth is
likely lean mass, consisting of bone and muscle growth.
"You
want to see babies growing in both weight and length," said Hair.
She
also noted that the volume of milk given to these infants cannot change to help
them grow because their stomach and intestine can only tolerate a certain
amount of feedings.
"You
cannot give them more volumes of milk. Especially if they have lung problems,
they have to have a certain volume of milk. This is a way to add calories but
not change the volume of milk," she said.
Since
November 2013, the NICU at Texas Children's Hospital has changed its protocol
to add this cream supplement to the diet of infants who weigh less than 1,500
grams.
"This
also emphasizes the importance of donating excess breast milk that your baby
doesn't need to a milk bank. It can help nourish our tiniest and most
vulnerable infants," said Hair.
Texas
Children's was the first hospital in the world to add human milk-based cream to
the diets of very low birth weight infants.
In
addition to adding cream to the diets of premature infants, since 2009, Texas
Children's has significantly reduced its rates of necrotizing enterocolitis,
one of the most devastating and potentially fatal diseases a neonate can face,
by implementing a human milk feeding protocol for all infants weighing less
than 3.3 pounds.
"Texas
Children's strives to be a leader in human milk feeding, because we know it
impacts outcomes," said Hair.
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