448 - Growth velocity in preterm infants fed mother’s own milk or donor human milk

Poster Number: 448
Publication Number: 448.335

Faesal Elbakoush, Children's Hospital of Michigan, Dearborn, MI, United States; Pradeep Kumar Velumula, Mercy One Waterloo Medical Center, Waterloo, IA, United States; monika Bajaj, Central Michigan University College of Medicine, Detroit, MI, United States; Girija Natarajan, Central Michigan University College of Medicine, Detroit, MI, United States; Hiba I I. Elfadeel, Select your Organization, New haven, CT, United States

Background: Donor human milk (DHM) is used for preterm infants when mother’s own milk (MOM) is unavailable. The different nutrient composition and microbial concentration of DHM and MOM can impact growth and other benefits to the neonate

Objective: To compare growth velocity (GV) and short-term neonatal outcomes in preterm infants fed MOM fortified with human milk-based fortifier (HMBF) to DHM fortified with HMBF.

Design/Methods: Retrospective study of preterm infants (birth weight ≤1,250 grams) fed exclusive human milk diet from 2013-2021was conducted. Infants who received formula or mix of breast milk and formula and those with congenital anomalies affecting feeding were excluded. We use HMBF to fortify MOM and DHM when an infant tolerates between 80-100 ml/kg/day of oral feeds. At 32 weeks postmenstrual age (PMA), DHM is transitioned to formula and HMBF to bovine milk based fortifier over a period of 4 days. Data on demographics, perinatal history, feeding, growth and short term neonatal morbidities (late onset sepsis, necrotizing enterocolitis > Stage IIa, length of stay, bronchopulmonary dysplasia, Grades 3 and 4 intraventricular hemorrhage (IVH) and retinopathy of prematurity) were collected. Weight GV was calculated from birth to 32 weeks PMA and from birth to discharge using the exponential model. Statistical analysis included chi square, t-test and Mann Whitney-U test as appropriate. Linear regression analysis was conducted to compare GV after adjusting for gestational age (GA), antenatal steroids and small for gestational age (SGA) status; p < 0.05 was considered significant.

Results: Our study cohort (n= 111) had a mean (SD) GA of 26.3 (1.9) weeks and birth weight of 848 (229) grams; 49 (44.1%) were male. Infants in the MOM group (n=55) had significantly lower GA and birth weight and required more respiratory support after birth (Table 1); regained birth weight later but had fewer NPO days (Table 2). On regression analysis after adjusting (GA, any steroid, SGA), no significant difference was observed between the two groups in GV from birth to 32 weeks PMA (β-coefficient 0.77, 95% CI -0.57-2.1, P 0.26) and from birth to discharge (β -coefficient 0.62, 95% CI -0.20-1.4, P 0.14). Short term neonatal outcomes were similar between the two groups (Table 3).Conclusion(s): In a single center study of preterm infants, we did not find any difference in GV and short-term neonatal outcomes between DHM fed and MOM fed infants. Further studies with large sample size exploring long term outcomes are warranted.
Table 1. Baseline Characteristics of Study Cohort
Table 2. Feeding and Growth Outcomes during hospital stay