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. 2023 Jun;93(7):2028-2035.
doi: 10.1038/s41390-022-02364-6. Epub 2022 Nov 10.

Effects of human milk on body composition and growth in very low birthweight infants

Carina B Ramirez #  1   2 , Karli L McCoy #  3   4 , Rachel Jacob  4 , Elizabeth Lavender  4 , Krista Bonagurio  4 , Diana Anzueto Guerra  3 , Simon Karottakuttu  5 , Jonathon Gelfond  6 , Donald McCurnin  3   4 , Cynthia L Blanco  3   4 , Alvaro G Moreira  3   4
Affiliations

Effects of human milk on body composition and growth in very low birthweight infants

Carina B Ramirez et al. Pediatr Res. 2023 Jun.

Abstract

Objective: To compare body composition and growth in very low birthweight infants according to their source of human milk: maternal expressed breast milk (MEBM) versus donor breast milk (DBM). We hypothesized that infants fed predominately MEBM would exhibit reduced body fat percentage compared to those fed predominately DBM.

Methods: Premature infants weighing ≤1500 g on an exclusive human milk diet were enrolled in a single-center study between 2017 and 2021. Demographic data and anthropometric measurements were collected. All infants underwent body composition analysis via dual energy x-ray absorptiometry at 36 weeks corrected post menstrual age.

Results: A total of 60 infants were enrolled and 48 were included in the primary analysis. No differences were detected in percent body fat (14 vs. 12%, p = 0.7) or fat-free mass (2050 vs. 2130 g, p = 0.7). Both groups displayed similar growth and anthropometric measurements. Caloric and macronutrient intake between groups was similar.

Conclusion: In the cohort of patients studied, no differences were observed in percent body fat based on primary human milk type intake in the first 28 postnatal days. Further investigation is required in a larger population of exclusive human milk fed preterm infants to determine if body composition differences exist based on an infant's primary human milk source.

Impact: Premature infants are at risk for altered body composition at term corrected age, specifically increased body fat percentage, which may have implications for the future. To our knowledge this is the first study exploring body composition outcomes based on an infant's primary human milk source. Infants fed exclusive human milk (e.g., donor vs. maternal) displayed similar percent body fat and growth outcomes.

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Conflict of interest statement

Competing interests: Dr. Cynthia Blanco has received financial support from Prolacta Bioscience® for an unrelated research project. The products described in this study were part of standard of care at University Health Systems. Prolacta Bioscience® provided no financial support or scientific input for this study. The remaining authors of this study have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Enrollment flow chart PMA=post menstrual age, MEBM = maternal expressed breast milk, DBM = donor breast milk
Figure 2
Figure 2
A. Fat free mass according to feed type. Whisker plot box for fat free mass between groups (MEBM vs. DBM). B. Pearson’s correlation between percent body fat and maternal expressed breast milk intake.
Figure 3.
Figure 3.
Measured enteral and parenteral calories and macronutrient content at 7, 14, 21, and 28 postnatal days. (A)Total caloric intake between donor breast milk (DBM) and maternal expressed breast milk (MEBM) groups. (B) Total protein intake between DBM and MEBM groups. (C)Total fat intake between DBM and MEBM groups. (D) Total carbohydrate intake between DBM and MEBM groups. Key: White: postnatal day 7, Dotted: postnatal day 14, Striped: postnatal day 21, Checked: postnatal day 28 *Significant linear effect of time (p<0.01, repeated measures anova with post-hoc test of trends). For both DBM and MEBM groups, there is a significant positive linear relationship between timepoint and kcal and between timepoint and total fat
See this image and copyright information in PMC

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