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Postnatal Growth Restriction and Association with Exclusive Breastfeeding in Neonates with a Birthweight Less than 1500 Grams

  • Gabriela Bolea Muguruza
    Hospital Universitario Burgos gabrielabmuguruza[at]gmail.com
  • Cristina de Frutos Martínez
    Hospital Universitario de Burgos
  • Laura Carlota García Miralles
    Hospital Universitario de Burgos
  • Mª Teresa Tamayo Martínez
    Hospital Universitario de Burgos
  • Judith Martín Corral
    Hospital Universitario de Burgos
https://doi.org/10.14201/rlm.30743

Abstract

Objetives: to define the incidence of postnatal growth failure (PGF) in very low birth weight infants (birth weight < 1500 g; VLBW), analyzing the impact of increasing exclusive human milk rates and the use of donor milk. Material and methods: Quasi-experimental study in VLBW infants divided into two groups regarding an intervention to optimize breastfeeding practices, including the availability of donor milk: group 1 (PRE-intervention: January 2016-May 2018) and group 2 (POST-intervention: June 2018 -December 2020). Weight, length and head circumference were recorded at birth, 28 days postnatal, 36 weeks of postmenstrual age and at discharge. Raw data were transformed into z-score and percentile in reference to Intergrowth-21st standards. The progress of these variables and the possible differences in both groups were analyzed. Results: The study included 115 VLBW infants with a median gestational age of 29 weeks and median birthweight of 1235 g, 58 in group 1 and 57 in group 2. We found significant differences in the rates of breastfeeding between both groups during admission (22.4 % vs. 61.4 %; p < 0.001) and at discharge (39.7 % vs. 66.7 %; p = 0.004). At hospital discharge, 31 % had a weight below p10 and 19 % had head circumference below p10. Comparing both groups, there were no significant differences in postnatal growth restriction either at 36 weeks postmenstrual age (38.6 % vs. 33.9 %; p 0.35) or at discharge (34.5 % vs. 28.1 %; p 0.46).
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1. American Academy of Pediatrics Committee on Nutrition: Nutritional needs of low-birth-weight infants. Pediatrics. 1985;75(5):976-86.

2. Cacho NT, Parker LA, Neu J. Necrotizing enterocolitis and human milk feeding: A systematic review. Clin Perinatol [Internet]. 2017;44(1):49-67. Disponible en: http://dx.doi.org/10.1016/j.clp.2016.11.009

3. Patel AL, Johnson TJ, Engstrom JL, Fogg LF, Jegier BJ, Bigger HR et al. Impact of early human milk on sepsis and health-care costs in very low birth weight infants. J Perinatol [Internet]. 2013;33(7):514-9. Disponible en: http://dx.doi.org/10.1038/jp.2013.2

4. Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J. Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;30:475-90.

5. Global breastfeeding investment case. The Investment Case for Breastfeeding: Nurturing the Health and Wealth of Nations. UNICEF, WHO; 2017.

6. The Baby-friendly Hospital Initiative for small, sick and preterm newborns. Geneva: World Health Organization and the United Nations Children’s Fund (UNICEF); 2020.

7. Moro GE, Arslanoglu S, Bertino E, Corvaglia L, Montirosso R, Picaud J-C et al. XII. Human milk in feeding premature infants: Consensus statement: Consensus statement. J Pediatr Gastroenterol Nutr [Internet]. 2015;61 Suppl 1(1):S16-9. Disponible en: http://dx.doi.org/10.1097/01.mpg.0000471460.08792.4d

8. Agostoni C, Buonocore G, Carnielli VP, Curtis D, Darmaun M, Decsi D. ESPGHAN Committee on Nutrition. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010;50(1):85-91.

9. Gidrewicz DA, Fenton TR. A systematic review and meta-analysis of the nutrient content of preterm and term breast milk. BMC Pediatr [Internet]. 2014;14(1):216. Disponible en: http://dx.doi.org/10.1186/1471-2431-14-216

10. Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am [Internet]. 2013;60(1):49-74. Disponible en: http://dx.doi.org/10.1016/j.pcl.2012.10.002

11. Arslanoglu S, Moro GE, Ziegler EE. The Wapm Working Group On Nutrition. Optimization of human milk fortification for preterm infants: new concepts and recommendations. J Perinat Med. 2010;38(3):233-8.

12. Arslanoglu S, Boquien C-Y, King C, Lamireau D, Tonetto P, Barnett D. Fortification of human milk for preterm infants: Update and recomendations of the European Milk Bank Association (EMBA) Working Group on human milk fortification. Front Pediatr. 2019;7.

13. Cooke RJ, Ainsworth SB, Fenton AC. Postnatal growth retardation: a universal problem in preterm infants. Arch Dis Child Fetal Neonatal Ed [Internet]. 2004;89(5):F428-30. Disponible en: http://dx.doi.org/10.1136/adc.2001.004044

14. Ehrenkranz RA, Das A, Wrage LA, Poindexter BB, Higgins RD, Stoll BJ. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Early nutrition mediates the influence of severity of illness on extremely LBW infants. Pediatr Res. 2011;69:522-9.

15. Ávila-Álvarez A, Solar Boga A, Bermúdez-Hormigo C, Fuentes Carballal J. Restricción del crecimiento extrauterino en recién nacidos de menos de 1500 gramos de peso al nacer. Anales de Pediatría. 2018;89(6):325-32.

16. Villar J, Giuliani F, Barros F, Roggero P, Coronado Zarco IA, Rego MAS et al. Monitoring the postnatal growth of preterm infants: A paradigm change. Pediatrics [Internet]. 2018;141(2). Disponible en: http://dx.doi.org/10.1542/peds.2017-2467

17. González-García L, García-López E, Fernández-Colomer B, Mantecón-Fernández L, Lareu-Vidal S, Suárez-Rodríguez M et al. Extrauterine growth restriction in very low birth weight infants: Concordance between Fenton 2013 and INTERGROWTH-21st growth charts. Front Pediatr [Internet]. 2021;9:690788. Disponible en: http://dx.doi.org/10.3389/fped.2021.690788

18. Izquierdo Renau M, Aldecoa-Bilbao V, Balcells Esponera C, Del Rey Hurtado de Mendoza B, Iriondo Sanz M, Iglesias-Platas I. Applying methods for postnatal growth assessment in the clinical setting: Evaluation in a longitudinal cohort of very preterm infants. Nutrients [Internet]. 2019;11(11):2772. Disponible en: http://dx.doi.org/10.3390/nu11112772

19. Ehrenkranz RA, Dusick AM, Vohr BR, Wright LL, Wrage LA, Poole WK. Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatrics [Internet]. 2006;117(4):1253-61. Disponible en: http://dx.doi.org/10.1542/peds.2005-1368

20. Ong KK, Kennedy K, Castañeda-Gutiérrez E, Forsyth S, Godfrey KM, Koletzko B et al. Postnatal growth in preterm infants and later health outcomes: a systematic review. Acta Paediatr [Internet]. 2015;104(10):974-86. Disponible en: http://dx.doi.org/10.1111/apa.13128

21. Stevens TP, Shields E, Campbell D, Combs A, Horgan M, La Gamma EF et al. Statewide initiative to reduce postnatal growth restriction among infants <31 weeks of gestation. J Pediatr [Internet]. 2018;197:82-89.e2. Disponible en: http://dx.doi.org/10.1016/j.jpeds.2018.01.074

22. Shlomai O, Reichman N, Lerner-Geva B, Boyko L, Bar-Oz V. Population-based study shows improved postnatal growth in preterm very-low-birthweight infants between 1995 and 2010. Acta Paediatr. 2014;103:498-503.

23. Andrews ET, Ashton JJ, Pearson F, Beattie RM, Johnson MJ. Early postnatal growth failure in preterm infants is not inevitable. Arch Dis Child Fetal Neonatal Ed [Internet]. 2019;104(3):F235-41. Disponible en: http://dx.doi.org/10.1136/archdischild-2018-315082

24. Meier PP, Johnson TJ, Patel AL, Rossman B. Evidence-based methods that promote human milk feeding of preterm infants: An expert review. Clin Perinatol [Internet]. 2017;44(1):1-22. Disponible en: http://dx.doi.org/10.1016/j.clp.2016.11.005

25. Lee HC, Kurtin PS, Wight NE, Chance K, Cucinotta-Fobes T, Hanson-Timpson TA et al. A quality improvement project to increase breast milk use in very low birth weight infants. Pediatrics [Internet]. 2012;130(6):e1679-87. Disponible en: http://dx.doi.org/10.1542/peds.2012-0547

26. Parker MG, Patel AL. Using quality improvement to increase human milk use for preterm infants. Semin Perinatol [Internet]. 2017;41(3):175-86. Disponible en: http://dx.doi.org/10.1053/j.semperi.2017.03.007

27. Villar J, Giuliani F, Fenton TR, Ohuma EO, Ismail LC, Kennedy SH. Consortium I-s. INTERGROWTH-21st very preterm size at birth reference charts. Lancet. 2016;387:844-5.

28. Jobe AH, Bancalari E. NICHD/NIH Workshop summary: bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163:1723-9.

29. Sáenz de Pipaón M, Martínez-Biarge M, Dorronsoro I, Salas S, Madero R, Martos GÁ et al. Growth in preterm infants until 36 weeks’ postmenstrual age is close to target recommendations. Neonatology [Internet]. 2014;106(1):30-6. Disponible en: http://dx.doi.org/10.1159/000358479

30. García-Muñoz Rodrigo F, Figueras Aloy J, Saavedra Santana P, García-Alix A. Crecimiento posnatal hasta el alta hospitalaria en recién nacidos extremadamente prematuros españoles. An Pediatr (Barc) [Internet]. 2017;87(6):301-10. Disponible en: http://dx.doi.org/10.1016/j.anpedi.2016.10.011

31. Rochow N, Raja P, Liu K, Fenton T, Landau-Crangle E, Göttler S et al. Physiological adjustment to postnatal growth trajectories in healthy preterm infants. Pediatr Res [Internet]. 2016;79(6):870-9. Disponible en: http://dx.doi.org/10.1038/pr.2016.15

32. Vidal K, Aloyb F, Pujolc N, Platasa I, Serrano M, Pérez C, Martín-Ancel F. Restricción posnatal del crecimiento en recién nacidos españoles de muy bajo peso con edad gestacional menor o igual a 32 semanas. Anales de Pediatría. 2018;68(3):206-12.

33. Embleton NE, Pang N, Cooke RJ. Postnatal malnutrition and growth retardation: an inevitable consequence of current recommendations in preterm infants? Pediatrics. 2001;107(2):270-3.

34. Clark RH, Thomas P, Peabody J. Extrauterine growth restriction remains a serious problem in prematurely born neonates. Pediatrics [Internet]. 2003;111(5 Pt 1):986-90. Disponible en: http://dx.doi.org/10.1542/peds.111.5.986

35. Hanigainathan S, Abiramalatha T. Early fortification of human milk versus late fortification to promote growth in preterm infants. Cochrane Database of Systematic Reviews. 2020;7:1057-68.

36. Maas C, Wiechers C, Bernhard W, Poets CF, Franz AR. Early feeding of fortified breast milk and in-hospital-growth in very premature infants: a retrospective cohort analysis. BMC Pediatr [Internet]. 2013;13(1):178. Disponible en: http://dx.doi.org/10.1186/1471-2431-13-178

37. Vázquez DC, García SS, Renau MI. Iglesias-Platas, I. Aviability of donor milk for very preterm infants decreased the risk of necrotizing enterocolitis without adversely impacting growth or rates of breastfeeding. Nutrients. 2019;11(8).

38. Boquien C-Y. Human milk: An ideal food for nutrition of preterm newborn. Front Pediatr [Internet]. 2018;6:295. Disponible en: http://dx.doi.org/10.3389/fped.2018.00295

Bolea Muguruza, G., de Frutos Martínez, C., García Miralles, L. C., Tamayo Martínez, M. T., & Martín Corral, J. (2023). Postnatal Growth Restriction and Association with Exclusive Breastfeeding in Neonates with a Birthweight Less than 1500 Grams. Revista De Lactancia Materna, 1(1), e30743. https://doi.org/10.14201/rlm.30743
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