Optimizing Nutrition in VLBW Infants – Evaluating Feeding Strategies

Study Focus:

A prospective, open-label, randomized controlled trial conducted at Kasturba Hospital, Manipal, assessed the impact of three feeding strategies on growth outcomes in preterm very low birth weight (VLBW) infants appropriate for gestational age (AGA).

Study Population:

120 preterm AGA infants (GA 28–32 weeks; BW 1000–1500 g) were randomized into three groups:

Group 1: Expressed breast milk (EBM) only
Group 2: EBM + Human Milk Fortifier (HMF)
Group 3: EBM + Preterm Formula Feed (PTF)

Primary Outcomes:

Growth parameters—weight, length, head circumference—were monitored at regular intervals until 6 weeks or discharge.

Key Findings (at 6 weeks/discharge):

HMF Group showed superior growth:
Mean weight: 2053±251 g
Mean length: 44.6±1.9 cm
Mean head circumference: 32.9±1.4 cm
PTF Group:
Mean weight: 1968±203 g
Mean length: 43.6±2.0 cm
Mean head circumference: 32.0±1.6 cm
EBM-only Group (lowest growth outcomes):
Mean weight: 1873±256 g
Mean length: 43.0±2.0 cm
Mean head circumference: 31.4±1.6 cm

Clinical Implications:

Human Milk Fortifier supplementation (1 g per 25 ml EBM) significantly enhances weight gain and head growth in VLBW infants.
Growth advantages were evident only by 6 weeks, not earlier.
Cost and feed intolerance remain limiting factors for widespread HMF use.

Bottom Line for Clinicians:

In VLBW AGA infants, fortifying breast milk with HMF can lead to improved postnatal growth outcomes. However, clinicians should balance the benefits with financial constraints and monitor for feeding tolerance. Long-term safety and developmental outcomes of HMF use warrant further investigation.

Reference:

Pedaveeti M, Iqbal F, Purkayastha J, et al. Indian J Pediatr. 2024 Jan 11:1–7.

IJCP Editorial Team

Comprising seasoned professionals and experts from the medical field, the IJCP editorial team is dedicated to delivering timely and accurate content and thriving to provide attention-grabbing information for the readers. What sets them apart are their diverse expertise, spanning academia, research, and clinical practice, and their dedication to upholding the highest standards of quality and integrity. With a wealth of experience and a commitment to excellence, the IJCP editorial team strives to provide valuable perspectives, the latest trends, and in-depth analyses across various medical domains, all in a way that keeps you interested and engaged.