Tolerance of Hydrolyzed Liquid Protein Fortified Human Milk and Effect on Growth in Premature Infants. Nutr Clin Pract 2019 Jun;34(3):450-458
Date
10/16/2018Pubmed ID
30320413DOI
10.1002/ncp.10193Scopus ID
2-s2.0-85055017447 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: We evaluated tolerance of hydrolyzed liquid protein (LP) supplement added to fortified human milk (HM) to optimize protein intake in preterm infants.
METHODS: A prospective observational study of 31 subjects compared with 31 historic controls, receiving mothers own milk (MOM) and/or donor milk (DM) to assess LP tolerance, growth, and risk for morbidities was conducted. Milk was analyzed for nutrient content. Feeding intolerance, defined as cessation of feedings for ≥48 hours, abdominal distension and/or residuals, necrotizing enterocolitis (NEC), and metabolic acidosis were used to assess safety, while weight and head circumference (HC) were used to evaluate growth.
RESULTS: LP added to powder-fortified HM had no impact on feeding intolerance and NEC. Biochemical parameters showed no metabolic acidosis: blood urea nitrogen levels (first week: median, 13 mg/dL; interquartile range [IQR], 9-16; last week: median, 13 mg/dL; IQR, 10.3-14; P = .94), bicarbonate levels (first week: median, 26.3 mEq/L; IQR, 24-28; last week: median, 28 mEq/L; IQR, 26.3-29.8; P = .10), and pH levels (first week: median, 7.4; IQR, 7.3-7.4; last week: median, 7.4; IQR, 7.37-7.40; P = .5). Weight and HC were not statistically significant. HM analysis showed lower protein and caloric content, respectively (MOM: 0.88 vs DM: 0.77 g/100 mL; P < .0001 and MOM: 18.68 vs DM: 17.96 kcal/oz; P = .02).
CONCLUSIONS: Hydrolyzed LP is well tolerated in preterm infants with no difference in growth rates. Clinicians should focus on the need to maximize both protein and energy to optimize growth.
Author List
Shakeel F, Newkirk M, Altoubah T, Martinez D, Amankwah EKAuthor
Ernest Amankwah PhD Director, Associate Professor in the Clinical and Translational Science Institute department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Energy IntakeEnteral Nutrition
Female
Food Intolerance
Food, Fortified
Gestational Age
Humans
Infant
Infant Nutritional Physiological Phenomena
Infant, Newborn
Infant, Newborn, Diseases
Infant, Premature
Infant, Very Low Birth Weight
Intensive Care, Neonatal
Male
Milk, Human
Prospective Studies
Protein Hydrolysates