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Multicenter Study
. 2022 Nov;42(11):1485-1488.
doi: 10.1038/s41372-022-01513-3. Epub 2022 Sep 28.

Neurodevelopmental outcomes of extremely preterm infants fed an exclusive human milk-based diet versus a mixed human milk + bovine milk-based diet: a multi-center study

Amy B Hair  1 , Aloka L Patel  2 , Ursula Kiechl-Kohlendorfer  3 , Jae H Kim  4 , Richard J Schanler  5 , Keli M Hawthorne  6 , Elena Itriago  7 , Steven A Abrams  6 , Cynthia L Blanco  8
Affiliations
Multicenter Study

Neurodevelopmental outcomes of extremely preterm infants fed an exclusive human milk-based diet versus a mixed human milk + bovine milk-based diet: a multi-center study

Amy B Hair et al. J Perinatol. 2022 Nov.

Abstract

Objective: The objective of this multi-center study was to compare, in infants ≤1250 g birth weight (BW) with neurodevelopmental assessment at 18-22 months of corrected age (CA), whether their neurodevelopmental outcomes differed based on exposure to an exclusive human milk-based (HUM) or to a bovine milk-based fortifier and/or preterm formula (BOV).

Study design: Retrospective multi-center cohort study of infants undergoing neurodevelopmental assessment as to whether HUM or BOV exposure related to differences in outcomes of infants at 18-22 months CA, using the Bayley Scales of Infant Development III (BSID-III). BSID-III cognitive, language, and motor scores were adjusted for BW, sex, study site, and necrotizing enterocolitis.

Results: 252 infants from 6 centers were included. BSID-III cognitive scores were higher in the HUM group (96.5 ± 15.1 vs 89.6 ± 14.1, adjusted p = 0.0001). Mean BSID-III language scores were 85.5 ± 15.0 in HUM and 82.2 ± 14.1 in BOV (adjusted p = 0.09). Mean BSID-III motor scores were 92.9 ± 11.7 in HUM and 91.4 ± 14.6 in BOV (adjusted p = 0.32).

Conclusion: In this cohort of infants undergoing neurodevelopmental assessment, infants receiving HUM diet had significantly higher cognitive BSID-III scores at 18-22 months CA. Further investigation is needed of this potential for HUM to positively influence infant cognitive outcomes.

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Conflict of interest statement

Drs. Hair and Blanco receive research support from Prolacta Bioscience for unrelated studies: human milk cream study and cardiac study. Neither received any industry funding for this study. Dr. Aloka Patel received a research grant from Prolacta Bioscience for her site’s contribution to the project. Dr. Kiechl-Kohlendorfer receives speaker honoraria from Prolacta Bioscience and Chiesi. Ms. Hawthorne receives speaker honoraria from Prolacta Bioscience and Abbott Nutrition. Dr. Kim has received consultant or advisor fees from Medela, and Evolve Biosystems; owns shares in Nicolette and Astarte Medical, and is on the Board of Directors for Innara Health. None of these entities or funding bodies had any role in the manuscript. Dr. Abrams, Dr. Itriago, and Dr. Schanler declare no financial conflicts of interest.

References

    1. Sullivan S, Schanler RJ, Kim JH, Patel AL, Trawoger R, Kiechl-Kohlendorfer U, et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr. 2010;156:562–7. e1. doi: 10.1016/j.jpeds.2009.10.040. - DOI - PubMed
    1. Cristofalo EA, Schanler RJ, Blanco CL, Sullivan S, Trawoeger R, Kiechl-Kohlendorfer U, et al. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. J Pediatrics. 2013;163:1592–5. doi: 10.1016/j.jpeds.2013.07.011. - DOI - PubMed
    1. Abrams SA, Schanler RJ, Lee ML, Rechtman DJ. Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products. Breastfeed Med. 2014;9:281–5. doi: 10.1089/bfm.2014.0024. - DOI - PMC - PubMed
    1. Hopperton KE, O’Connor DL, Bando N, Conway AM, Ng DV, Kiss A, et al. Maternal and pediatric nutrition nutrient enrichment of human milk with human and bovine milk-based fortifiers for infants born <1250 g: 18-month neurodevelopment follow-up of a randomized clinical trial. Curr Dev in Nutr. 2019;3:nzz129. - PMC - PubMed
    1. Colacci M, Murthy K, Deregnier RAO, Khan JY, Robinson DT. Growth and development in extremely low birth weight infants after the introduction of exclusive human milk feedings. Am J Perinatol. 2017;34:130–7. doi: 10.1055/s-0036-1584520. - DOI - PubMed

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