Tuan Tran. Neonatal Outcomes Based on Nutritional Supplementation of Formula and HumanBbreastmilk with Fortifiers

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Author/Presenter:  Tuan Tran, MD1
Resident, University of Texas Medical Branch, Pediatrics
 
Contributing Authors/Faculty Mentors: Michael Malloy, MD, MS1,2; Rafael Fonseca, MD1,2

1University of Texas Medical Branch, Pediatrics
2Division of Neonatology


POSTER ABSTRACT   (View Poster PDF)

Background: Optimizing neonatal nutrition to imitate normal intrauterine growth has been an overarching goal that neonatal intensive care units strive towards. Over the past decade earlier and more aggressive advancing of enteral feeding has been a goal in addition to a greater utilization of supplemented human breast milk. The purpose of this study was to analyze a sample population of extremely low birth weight neonates (ELBW) in an earlier period of time, prior to the emphasis of rapid advancing of enteral nutrition, to compare success in actually achieving the goal of earlier and greater caloric intake and to compare growth outcomes.

Methods: Data were collected on ELBW preterm infants (<1000 g) from two time periods in 2009-2010 and 2014-2017. From these groups, the type of enteral intake (Similac Special Care) or human breast milk with fortifiers (Prolacta Plus); the enteral and total caloric intake; and the change from birth weight at 2 weeks, 30 days, and 36 weeks corrected gestational age (cGA) were recorded. In addition, the days to reaching 100 kcal/kg/day and those with a diagnosis of failure to thrive (FTT) at 36 weeks cGA (defined as <10th percentile) were analyzed.

Results: Epoch 2 (2014-2017) when compared to Epoch 1 (2009-2010) had significant increases in weight from birth weight at 2 weeks and 30 days old (p-value <0.05). However, at 36 weeks cGA there was no significant difference found between the two groups (p-value 0.61). There was a significant increase (p-value <0.05) in enteral and total calories given in Epoch 2 when compared to Epoch 1. Interestingly, there was no significant difference in the percent of infants classified as FTT at 36 weeks cGA (86.0% vs 86.7%, Epoch 1 vs Epoch 2).

Conclusions: Despite more aggressive and early enteral feeding, ELBW neonates showed no difference in weight changes at 36 weeks cGA nor any difference in the percent classified as FTT compared to an earlier group who did not receive such an aggressive approach