NICU Human Milk Dose and 20-Month Neurodevelopmental Outcome in Very Low Birth Weight Infants. Neonatology 2017;112(4):330-336
Date
08/03/2017Pubmed ID
28768286Pubmed Central ID
PMC5683911DOI
10.1159/000475834Scopus ID
2-s2.0-85026885998 (requires institutional sign-in at Scopus site) 55 CitationsAbstract
BACKGROUND: The association between human milk (HM) feeding in the NICU and neurodevelopmental (ND) outcome in very low birth weight (VLBW) infants is unclear. Limitations of previous studies include a lack of exact estimates of HM dose and of generalizability to minority populations.
OBJECTIVE: To determine the impact on ND outcome of an exact dose of HM received in the NICU in a diverse, contemporary cohort of VLBW infants.
METHODS: We included 430 VLBW infants born in the period 2008-2012 for whom the mean daily dose (DD) of HM received during the stay in the NICU (NICU HM-DD) was calculated prospectively from the daily nutritional intake from admission to discharge. Outcomes included Bayley-III index scores at 20 months' corrected age (CA) as assessed upon ND follow-up, which were collected retrospectively. Multivariable linear regression analyses controlled for neonatal and social risk factors.
RESULTS: Each 10 mL/kg/day increase in NICU HM-DD was associated with a 0.35 increase in cognitive index score (95% CI [0.03-0.66], p = 0.03), but no significant associations were detected for the language or motor indices.
CONCLUSIONS: There is a significant dose-dependent association between NICU HM intake and cognitive scores at 20 months' CA. Further follow-up will determine whether these findings persist at school age, and could help alleviate the special-education and health-care burden in this population.
Author List
Patra K, Hamilton M, Johnson TJ, Greene M, Dabrowski E, Meier PP, Patel ALAuthor
Elizabeth Dabrowski MD Assistant Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Age FactorsBirth Weight
Child Development
Child Language
Cognition
Female
Humans
Infant
Infant Nutritional Physiological Phenomena
Infant, Newborn
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Linear Models
Male
Milk, Human
Motor Activity
Multivariate Analysis
Nervous System
Nutritional Status
Nutritive Value
Prospective Studies
Retrospective Studies