Growth, Tolerance, and Morbidity of Preterm Infants Fed Exclusively Human Milk, Exclusively Preterm Infant Formula, or a Combination of Human Milk and a Preterm Infant Formula until Term Corrected Age (CA)

Abstract 1693 Poster Session III, Monday, 5/3 (poster 73)

Given the many benefits of feeding human milk to both term and preterm infants, policies have been implemented in NICUs to support the provision of human milk to infants. Purpose: To determine the impact of type of feeding on the growth, in-hospital feeding tolerance, and morbidity of premature infants. Design: Infants (n=463) with birthwts of 750 to 1800g (<33 wk GA) were enrolled within 72 hrs of first enteral feeding (study day 1, SD1) from 17 NICUs in 9 locations in the UK, US, and Chile. Timing of initiation and advancement of enteral feeds, the duration of human milk feeding, and decision regarding supplementation of enteral feeds was entirely at the discretion of the medical staff, except that the enteral feeding goal was ≥120 kcal/kg/d. If human milk was fed,it was suggested that it be fortified to 22 - 24 kcal/fl oz and a minimum concentration of 2.8 g/kg/d protein. Infants were followed until they were term CA. Main Outcomes: Growth (weight, length and head circumference [HC]) to hospital discharge [HD] and term CA, in-hospital and post-discharge morbidity were assessed. Results: Forty-three, 98, 202 and 120 infants were classified as being exclusively human milk fed (EHM), receiving < 50% of total in-hospital enteral energy intake from formula (M1), receiving ≥50% of total in-hospital enteral energy intake from formula (M2), or exclusively formula fed 9DFF), respectively. The LS means ±SEM for weight at HD among infants in the EHM, M1, M2 and EFF groups was 1989±62, 1993±43, 2232±29 and 233±37, respectively (P<0.0001). Similar differences in wt at term CA (P<0.0001), and length and HC at HD and term CA (P<0.01) were observed. No differences in in-hospital morbidity or post-discharge morbidity among feeding groups were found. Conclusion: Growth of preterm infants to term Ca is inversely related to the % of total energy consumed as human milk. The functional significance of these observations warrants further investigation. Funded by Abbott Laboratories.