A RANDOMIZED, CONTROLLED EVALUATION OF 2 COMMERCIALLY AVAILABLE HUMANBREAST-MILK FORTIFIERS IN HEALTHY PRETERM NEONATES

Citation
K. Sankaran et al., A RANDOMIZED, CONTROLLED EVALUATION OF 2 COMMERCIALLY AVAILABLE HUMANBREAST-MILK FORTIFIERS IN HEALTHY PRETERM NEONATES, Journal of the American Dietetic Association, 96(11), 1996, pp. 1145-1149
Citations number
21
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Nutrition & Dietetics
ISSN journal
0002-8223
Volume
96
Issue
11
Year of publication
1996
Pages
1145 - 1149
Database
ISI
SICI code
0002-8223(1996)96:11<1145:ARCEO2>2.0.ZU;2-U
Abstract
Objective To evaluate the added nutritional value of the two commercia lly available human breast milk fortifiers: Similac Natural Care (NC) and Enfamil Powder (EP). Design A randomized controlled evaluation in healthy preterm neonates. Setting Neonatal Intensive Care Unit, Royal University Hospital, Saskatoon, Saskatchewan, and Neonatal Intensive C are Unit, Jewish General Hospital, Montreal, Quebec, Canada. Subjects Healthy preterm infants admitted to and cared for in the aforementione d neonatal intensive care units. Interventions Healthy preterm neonate s who were receiving expressed breast milk from their own mothers were supplemented with human milk fortifiers (NC and EP) per manufacturer' s recommendations. Main outcome measures Gestational age and birth wei ght, gender, and race. At entry to and exit from the study. serum conc entrations of albumin, protein, calcium, phosphorus, and alkaline phos phatase. The age at which the supplements were added and the number of days the infant remained in the hospital. Daily weight gain, head cir cumference, length, and height were also measured. Statistical analyse s performed Student's t test was used to test the differences between the groups and within the groups at entry to and exit from the study. Fisher's exact test was used to determine differences in race, size, a nd gestational age in each group. When necessary, a chi(2) test was us ed to analyze the preponderance of either sex in each group. A Wilcoxo n rank test was applied to the true exit date to determine whether the bias was comparable in each group. Results The mean (+/- standard err or) gestational age and birth weight were similar in both groups: 30+/ -0.3 weeks and 1,314+/-40 g, respectively, for NC vs 29.6+/-0.35 weeks and 1,262+/-45 g, respectively, for EP. At entry to the study, values for the NC group (N=29) were albumin 31+/-1.2, g/L, serum protein 48/-1.4 g/L, calcium 2.4+/-0.03 mmol/L, phosphorus 1.85+/-0.08 mmol/L, a lkaline phosphatase 347+/-27 IU/L. The values for the EF group (N=30) were albumin 32+/-0.9 g/L, serum protein 49+/-1.4 g/L, calcium 2.4+/-0 .4 mmol/L, phosphorus 1.9+/-0.1 mmol/L, alkaline phosphatase 420+/-34 IU/L. At the study exit, the values for the NC group were albumin 30+/ -0.7 g/L, serum protein 45+/-0.9 g/L, calcium 2.4+/-0.3 mmol/L, phosph orus 1.96+/-0.07 mmol/L, and alkaline phosphatase 371+/-23 IU/L. The v alues for the EP group were albumin 32+/-1.0 g/L, serum protein 46.0+/ -1.4 g/L, calcium 2.5+/-0.03 mmol/L, serum phosphorus 2.2+/-0.1, and a lkaline phosphatase 367+/-27 IU/L. No significant differences were obs erved between groups at entry to and exit from the study. However, in the EP group the alkaline phosphatase decreased significantly (P=.02) from entry to exit and calcium increased significantly during the same period compared with the NC group (P=.003). The mean daily weight gai n was 33+/-0.7 g for the NC group and 31+/-1 g for the EP group. The w eekly gain in head circumference and body length were also similar in both groups: approximately 1 cm/week. Both groups tolerated the fortif iers well. Applications/conclusions These findings suggest that both p roducts provide the additional nutritional support necessary for optim al overall postnatal growth in healthy preterm infants. The difference s in calcium and alkaline phosphatase may be due to the differences in vitamin D content in fortifiers 88 IU/100 mL in mixed NC vs 270 IU/10 0 mL in mixed EP. This observation calls for careful monitoring of cal cium and alkaline phosphatase values and possible adjustments of vitam in D intake when fortifiers are used for extended periods.