Autor:innen:
C. Binder (Vienna, AT)
E. Teunissen (Nijmegen, NL)
T. Kainz (Vienna, AT)
E. Calek (Vienna, AT)
K. Harreiter (Vienna, AT)
A. Berger (Vienna, AT)
A. Thajer (Vienna, AT)
Introduction
Mother´s own milk (MOM) is the gold standard for infants’ nutrition, particularly for preterm infants. Donor human milk (DHM) is recommended as the preferred alternative if MOM is not available. However, the effect of DHM compared to MOM on growth and body composition is not fully investigated so far. Body Composition, especially fat-free mass (FFM) is a valuable parameter to evaluate the nutritional status and a good prognostic marker for neonatal neurodevelopment. The aim of the study was to investigate the impact of MOM compared to DHM on growth and body composition in preterm infants.
Methods
In this retrospective study infants born < 32 weeks and < 1500grams between 2017-2022, who underwent air displacement plethysmography (Pea Pod®) to determine body composition (FFM and FM: fat mass) at term-equivalent age, were included. A comparison between infants fed with MOM > 50% (MOM-group) and infants fed with single preterm DHM > 50% (DHM-group) of the total volume of milk intake during hospital stay was conducted. A sample size of 286 infants was calculated to detect a 0.4% difference in FFM Z-Score between the groups (two tailed, power 80%). Multivariable regression model was used to examine the association between FFM- and FM-Z-Scores and the study groups with adjustment for the covariates: sex, age at birth, birth weight Z-Score, age, and length at measurement, and time on parenteral nutrition.
Results
351 infants were included for the analyses (MOM-group: n=145; DHM-group: n=206). Median (IQR) gestational age in weeks 26.6 (25.2, 28.1; MOM-group) and 27.0 (24.6, 28.2; DHM-group), (p=0.13) and median (IQR) birth weight 840g (675g, 1100g; MOM-group) and 800g (645g, 1100g; DHM-group), (p=0.09) were not significantly different between the groups. Median (IQR) time on parenteral nutrition in days was not significantly different between the groups ((MOM-group: 17 (12, 20) vs DHM-group: 18 (14, 21); (p=0.13)). Median weight and age at discharge were not significantly different between the groups (p=0.07, p=0.90, respectively). Median (IQR) age in weeks at body composition measurements was as follows: MOM-group, 42.1 (40.1, 44.5); DHM-group, 43.0 (40.2, 45.4), (p=0.07). Median (IQR) FFM-Z-Score was -0.8 (-1.8, 0.7; MOM-group) and -0.8 (-1.7, 0.5; DHM-group). FM-Z-Score was 1.4 (0.2, 2.8; MOM-group) and 1.5 (0.3, 2.8, DHM-group). FFM- und FM-Z-Scores were not significantly different between the groups (p=0.47; p=0.33).
Conclusion
We found that growth and body composition at term-equivalent age were not significantly different in infants who received primarily MOM compared to infants who received primarily single preterm DHM. This data showed that single preterm DHM is a good alternative to MOM and does not affect preterm infants’ growth and body composition. Further research is necessary the evaluate the effect on long-term neurodevelopment.