Effect of human milk enriched with human milk-based fortifier (HMBF) versus bovine milk-based fortifier (BMBF) on growth and morbidity among very low birth weight (VLBW) infants – A randomized controlled trial

Introduction: Survival of preterm neonates increased dramatically with the advancement in neonatology services. These infants have high nutritional demands for optimal growth, and human milk alone is insufficient to meet their needs. Hence, fortification of milk has become the standard of care. Bovi...

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Autores principales:	Rakesh Kotha, Kalyan Chakravarthy Konda, Paramesh Pandala, Alimelu Maddireddi
Formato:	article
Lenguaje:	EN IT
Publicado:	Hygeia Press di Corridori Marinella 2021
Materias:	human milk bmbf hmbf vlbw neonates perinatology nutrition Medicine R Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/aefcc568071f42fa91d8e5b8afbfa54d
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spelling	oai:doaj.org-article:aefcc568071f42fa91d8e5b8afbfa54d2021-11-17T20:42:14ZEffect of human milk enriched with human milk-based fortifier (HMBF) versus bovine milk-based fortifier (BMBF) on growth and morbidity among very low birth weight (VLBW) infants – A randomized controlled trial2281-069210.7363/110104https://doaj.org/article/aefcc568071f42fa91d8e5b8afbfa54d2021-11-01T00:00:00Zhttps://jpnim.com/index.php/jpnim/article/view/1045https://doaj.org/toc/2281-0692Introduction: Survival of preterm neonates increased dramatically with the advancement in neonatology services. These infants have high nutritional demands for optimal growth, and human milk alone is insufficient to meet their needs. Hence, fortification of milk has become the standard of care. Bovine milk-based fortifiers (BMBF) are commonly used, but there exists concern regarding the exposure to cow milk protein. Human milk-based fortifier (HMBF) use offers a theoretical advantage from the immunological and gastrointestinal standpoint. We intend to study the effects of HMBF compared to BMBF on growth and morbidity of preterm neonates. Methodology: It is a single-centre, open-labelled, randomized controlled trial (RCT) enrolling very low birth weight (VLBW) neonates of less than 34 weeks of gestation weighing between 1,000 and 1,500 g. Only human milk was used, and infants were randomized to receive either fortifier after reaching 100 ml/kg/day of enteral feeds. Growth and morbidity of preterm neonates were analysed. Results: A total of 50 infants were enrolled (25 in each arm). Weight gain (21.42 vs. 20.84 g/day, p = 0.77) and growth velocity (16.45 vs. 15.85 g/kg/day, p = 0.57) were similar in both groups with no statistical difference. Sepsis (relative risk [RR] = 0.6), feed intolerance (RR = 0.57), necrotizing enterocolitis (NEC) (RR = 0.33) and duration of hospital stay (33 vs. 36 days) were better in the HMBF group than in the BMBF group. Conclusion: Growth velocity was similar in both groups. However, HMBF was well tolerated by neonates with lesser incidence of feed intolerance, NEC, sepsis, and lesser hospital stay duration than in neonates supplemented with BMBF. Given the fewer number of studies, there is a need for well-powered RCTs with a good sample size to fill the knowledge gap.Rakesh KothaKalyan Chakravarthy KondaParamesh PandalaAlimelu MaddireddiHygeia Press di Corridori Marinellaarticlehuman milkbmbfhmbfvlbwneonatesperinatologynutritionMedicineRPediatricsRJ1-570ENITJournal of Pediatric and Neonatal Individualized Medicine, Vol 11, Iss 1, Pp e110104-e110104 (2021)
institution	DOAJ
collection	DOAJ
language	EN IT
topic	human milk bmbf hmbf vlbw neonates perinatology nutrition Medicine R Pediatrics RJ1-570
spellingShingle	human milk bmbf hmbf vlbw neonates perinatology nutrition Medicine R Pediatrics RJ1-570 Rakesh Kotha Kalyan Chakravarthy Konda Paramesh Pandala Alimelu Maddireddi Effect of human milk enriched with human milk-based fortifier (HMBF) versus bovine milk-based fortifier (BMBF) on growth and morbidity among very low birth weight (VLBW) infants – A randomized controlled trial
description	Introduction: Survival of preterm neonates increased dramatically with the advancement in neonatology services. These infants have high nutritional demands for optimal growth, and human milk alone is insufficient to meet their needs. Hence, fortification of milk has become the standard of care. Bovine milk-based fortifiers (BMBF) are commonly used, but there exists concern regarding the exposure to cow milk protein. Human milk-based fortifier (HMBF) use offers a theoretical advantage from the immunological and gastrointestinal standpoint. We intend to study the effects of HMBF compared to BMBF on growth and morbidity of preterm neonates. Methodology: It is a single-centre, open-labelled, randomized controlled trial (RCT) enrolling very low birth weight (VLBW) neonates of less than 34 weeks of gestation weighing between 1,000 and 1,500 g. Only human milk was used, and infants were randomized to receive either fortifier after reaching 100 ml/kg/day of enteral feeds. Growth and morbidity of preterm neonates were analysed. Results: A total of 50 infants were enrolled (25 in each arm). Weight gain (21.42 vs. 20.84 g/day, p = 0.77) and growth velocity (16.45 vs. 15.85 g/kg/day, p = 0.57) were similar in both groups with no statistical difference. Sepsis (relative risk [RR] = 0.6), feed intolerance (RR = 0.57), necrotizing enterocolitis (NEC) (RR = 0.33) and duration of hospital stay (33 vs. 36 days) were better in the HMBF group than in the BMBF group. Conclusion: Growth velocity was similar in both groups. However, HMBF was well tolerated by neonates with lesser incidence of feed intolerance, NEC, sepsis, and lesser hospital stay duration than in neonates supplemented with BMBF. Given the fewer number of studies, there is a need for well-powered RCTs with a good sample size to fill the knowledge gap.
format	article
author	Rakesh Kotha Kalyan Chakravarthy Konda Paramesh Pandala Alimelu Maddireddi
author_facet	Rakesh Kotha Kalyan Chakravarthy Konda Paramesh Pandala Alimelu Maddireddi
author_sort	Rakesh Kotha
title	Effect of human milk enriched with human milk-based fortifier (HMBF) versus bovine milk-based fortifier (BMBF) on growth and morbidity among very low birth weight (VLBW) infants – A randomized controlled trial
title_short	Effect of human milk enriched with human milk-based fortifier (HMBF) versus bovine milk-based fortifier (BMBF) on growth and morbidity among very low birth weight (VLBW) infants – A randomized controlled trial
title_full	Effect of human milk enriched with human milk-based fortifier (HMBF) versus bovine milk-based fortifier (BMBF) on growth and morbidity among very low birth weight (VLBW) infants – A randomized controlled trial
title_fullStr	Effect of human milk enriched with human milk-based fortifier (HMBF) versus bovine milk-based fortifier (BMBF) on growth and morbidity among very low birth weight (VLBW) infants – A randomized controlled trial
title_full_unstemmed	Effect of human milk enriched with human milk-based fortifier (HMBF) versus bovine milk-based fortifier (BMBF) on growth and morbidity among very low birth weight (VLBW) infants – A randomized controlled trial
title_sort	effect of human milk enriched with human milk-based fortifier (hmbf) versus bovine milk-based fortifier (bmbf) on growth and morbidity among very low birth weight (vlbw) infants – a randomized controlled trial
publisher	Hygeia Press di Corridori Marinella
publishDate	2021
url	https://doaj.org/article/aefcc568071f42fa91d8e5b8afbfa54d
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Effect of human milk enriched with human milk-based fortifier (HMBF) versus bovine milk-based fortifier (BMBF) on growth and morbidity among very low birth weight (VLBW) infants – A randomized controlled trial

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