skip to main content

Comparison of Very Low Birth Weight Preterm Infants with And Without Experienced Target Weight Gain on The Administration of Human Milk Fortifier

Faculty of Medicine, Diponegoro University, Indonesia

Received: 1 Oct 2020; Revised: 18 Dec 2020; Accepted: 23 Dec 2020; Available online: 31 Dec 2020; Published: 31 Dec 2020.
Open Access Copyright (c) 2020 Journal of Biomedicine and Translational Research

Citation Format:

Background: Human milk fortifier (HMF) is defined as a supplement added to breastmilk to increase calories, proteins, vitamins, and various nutrition of breastmilk. The purpose of HMF administration is to increase the concentration of breastmilk nutrients to improve the weight of very low birth weight preterm infants. The administration of HMF is insufficient to fulfill protein needs in 20-40% very low birth weight babies, thus the weight gain did not meet the expected target.

Objective: To analyze characteristic differences between very low birth weight preterm infants who experienced weight gain according to the target and not according to the target on the administration of HMF.

Methods: An analytical study with a case-control approach comparing case and control group, which was observed to determine characteristic differences between both groups. The samples were 52 very low birth weight preterm infants obtained by consecutive sampling. Data analysis includes descriptive analysis and hypothesis testing. 

Results: Data were obtained from medical records and consisted of 52 participants, including 26 very low birth weight premature infants who experienced weight gain according to the target and 26 who experienced weight gain not according to the target. There was no characteristic difference of cyanosis clinical symptoms (OR 2.3; 95% CI 0.51-10.4), chest retraction (OR 1.0; 95% CI 0.32-3.1), apnea of prematurity comorbid (OR 1.0; 95% CI 0.25-3.9), neonatal infections (OR 0.62; 95% CI 0.21-1.9), starting age of HMF administration (OR 0.62; 95% CI 0.21-1.89), bloating (OR 0.57; 95% CI 0.17-1.9), and vomiting (OR 1.18; 95% CI 0.38-3.7) in both groups.

Conclusion: There was no characteristic difference between very low birth weight preterm infants who experienced weight gain according to the target and not according to the target on the administration of HMF.

Note: This article has supplementary file(s).

Fulltext View|Download |  Research Instrument
Cover Letter
Subject preterm infants; VLBW; HMF
Type Research Instrument
  Download (63KB)    Indexing metadata
 Research Instrument
List of Potential Reviewer
Subject preterm infants; VLBW; HMF
Type Research Instrument
  Download (64KB)    Indexing metadata
Keywords: Preterm Infants; VLBW; HMF

Article Metrics:

  1. Eryigit Madzwamuse S, Baumann N, Jaekel J, Bartmann P, Wolke D. (2015). Neuro-cognitive performance of very preterm or very low birth weight adults at 26 years. J Child Psychol Psychiatry, 56(8):857-864
  2. Afjeh S-A, Sabzehei M-K, Fallahi M, Esmaili F. (2013). Outcome of very low birth weight infants over 3 years report from an Iranian center. Iran J Pediatr, 23(5):579-587
  3. Lansky S, Friche AA de L, Silva AAM da, Campos D, Bittencourt SD de A, Carvalho ML de. (2014). Pesquisa Nascer no Brasil: perfil da mortalidade neonatal e avaliação da assistência à gestante e ao recém-nascido. Cad Saude Publica, 30:192-207
  4. Arslanoglu S, Boquien C, King C, Lamireau D. (2019). Fortification of Human Milk for Preterm Infants: Update and Recommendations of the European Milk Bank Association (EMBA) Working Group on Human Milk Fortification. Front Pediatr, 7:1-14
  5. Tillman S, Brandon DH, Silva SG. (2012). Evaluation of human milk fortification from the time of the first feeding: effects on infants of less than 31 weeks gestational age. J Perinatol, 32:525-531
  6. Bertino E, Giribaldi M, Cester EA, Trapani BM, Peila C, Arslanoglu S. (2017). New human milk fortifiers for the preterm infant. J Pediatr Neonatal Individ Med, 6(1):1-7
  7. Lapillonne A, Griffin IJ. (2013). Feeding preterm infants today for later metabolic and cardiovascular outcomes. J Pediatr, 162(3):7-16
  8. Alyahya W, Garcia L, Mactier H, Edwards CA. (2019). Early versus Delayed Fortification of Human Milk in Preterm Infants : A Systematic Review. Neonatol J. doi: 10.1159/000501279
  9. Arslanoglu S, Moro GE, Ziegler EE. (2009) Preterm infants fed fortified human milk receive less protein than they need. J Perinatol, 29(7):489-492. doi: 10.1038/jp.2009.50
  10. Picaud J-C, Houeto N, Buffin R, Hays S. (2017). Additional protein fortification is necessary in extremely low birth weight infants fed human milk. J Pediatr Gastroenterol Nutr, 64:1-7
  11. Muhlhausler BS, Hancock SN, Bloomfield FH, Harding R. (2011). Are Twins Growth Restricted?. Int Pediatr Res Found, 70(2):117-122
  12. Yuan T, Wang W, Li X. (2020). Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case – control study. Medicine, 95:1-6
  13. Küpers LK, Abée CL, Bocca G, Stolk RP, Pieter J. (2015). Determinants of Weight Gain during the First Two Years of Life — The GECKO Drenthe Birth Cohort. PLoS One, 1-15. doi: 10.1371/journal.pone.0133326
  14. Ehsanpour S, Hemmati E, Abdeyazdan Z. (2012). Comparison of neonatal growth in normal, low and very low birth weights until 18 months. Iran J Nurs Midwifery Res, 131-136.
  15. Hiremath G, Kamat D. (2015). Diagnostic considerations in infants and children with cyanosis. Pediatr Ann, 44(2):76-80. doi: 10.3928/00904481-20150203-12
  16. Irving SY. (2011). Patterns of Weight Change in infants With Congenital Heart Disease Following Neonatal Surgery : Potential Predictors of Growth Failure Patterns of Weight Change in infants With Congenital Heart Disease. Publicly Accesible Penn Disertations, 11(2):443-446
  17. Mari MA, Cascudo MM, Alchieri JC. (2016). Congenital Heart Disease and Impacts on Child Development. Brazilian J Cardiovasc Surg, 31(1):31-37. doi: 10.5935/1678-9741.20160001
  18. Dylag IK, Myers RE. (2020). Poor Weight Gain, Cough, Shortness of Breath, and Chest Pain in an 11-year-old Boy. AAP Publ, 36(5)
  19. Niesłuchowska-Hoxha A, Cnota W, Czuba B, Alexandra R, Marcin S, Agata W et al. (2018). A Retrospective Study on the Risk of Respiratory Distress Syndrome in Singleton Pregnancies with Preterm Premature Rupture of Membranes between 24+0 and 36+6 Weeks, Using Regression Analysis for Various Factors. Daskalakis GJ, ed. Biomed Res Int. doi: 10.1155/2018/7162478
  20. Harada E, Kinoshita M, Iwata S. (2019). Visual function scale for identification of infants with low respiratory compliance. Pediatr Neonatol, 60(6):611-616. doi: 10.1016/j.pedneo.2019.02.006
  21. Saarenpää H-K, Tikanmäki M, Sipola-Leppänen M, Hovi P, Wehkalampi K. (2015). Lung Function in Very Low Birth Weight Adults. Pediatrics, 136(4):642 LP-650. doi: 10.1542/peds.2014-2651
  22. Kondamudi NP, Wilt AS. (2020). Infant Apnea. StatPearls Publishing. doi: 10.1038/leu.2016.20
  23. Mathew OP. (2011). Apnea of prematurity : pathogenesis and management strategies. J Perinatol, 302-310. doi: 10.1038/jp.2010.126
  24. Breij LM, Mulder MT, van Vark-van der Zee LC, Hokken-Koelega ACS. (2017). Appetite-regulating hormones in early life and relationships with type of feeding and body composition in healthy term infants. Eur J Nutr, 56(4):1725-1732. doi: 10.1007/s00394-016-1219-8
  25. Vergnano S, Buttery J, Cailes B, Elena C, Erbiere C, Jay K, et al. (2016). Neonatal infections: Case definition and guidelines for data collection, analysis, and presentation of immunisation safety data. Vaccine, 34(49):6038-6046. doi: 10.1016/j.vaccine.2016.03.046
  26. Ponterio E, Gnessi L. (2015). Adenovirus 36 and Obesity: An Overview. Viruses, 7(7):3719-3740. doi: 10.3390/v7072787
  27. Tambo A, Roshan MHK, Pace NP. (2016). The Microbial Hypothesis: Contributions of Adenovirus Infection and Metabolic Endotoxaemia to the Pathogenesis of Obesity. Schneider JG, ed. Int J Chronic Dis. doi: 10.1155/2016/7030795
  28. Dawson-Hahn EE, Rhee KE. (2019). The association between antibiotics in the first year of life and child growth trajectory. BMC Pediatr, 19(1):23. doi: 10.1186/s12887-018-1363-9
  29. Taheri PA, Sajjadian N, Fargi MA, Shariat M. (2016). Is early breast milk fortification more effective in preterm infants?: a clinical trial. J Perinat Med, 44:1-5
  30. Alyahya W, Garcia L, Mactier H, Edwards CA. (2019). Early versus Delayed Fortification of Human Milk in Preterm Infants: A Systematic Review. Neonatol J, 115:3-5
  31. Fanaro S. (2013). Feeding intolerance in the preterm infant. Early Hum Dev, 89:1-8. doi: 10.1016/j.earlhumdev.2013.07.013
  32. Morton DL, Hawthorne KM, Moore CE. (2017). Growth of Infants with Intestinal Failure or Feeding Intolerance Does Not Follow Standard Growth Curves. J Nutr Metab. doi: 10.1155/2017/8052606
  33. Chen A, Du J, Du L-Z. (2013). Clinical characteristics of abdominal distention in early newborns. Zhongguo Dang Dai Er Ke Za Zhi, 15(12):1074-1078

Last update:

No citation recorded.

Last update:

No citation recorded.