Published online June 2, 2008
PEDIATRICS Vol. 121 No. 6 June 2008, pp. e1528-e1533 (doi:10.1542/peds.2007-2110)
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ARTICLE

Human Milk Consumption and Full Enteral Feeding Among Infants Who Weigh ≤1250 Grams

Paula M. Sisk, PhDa, Cheryl A. Lovelady, PhDb, Kenneth J. Gruber, PhDc, Robert G. Dillard, MDa and T. Michael O'Shea, MD, MPHa

a Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina
b Department of Nutrition
c School of Environmental Science, University of North Carolina, Greensboro, North Carolina

OBJECTIVE. Establishing enteral feeding is an important goal in the care of very low birth weight infants. In such infants, receipt of ≥50 mL/kg per day human milk during hospitalization has been associated with shorter time to full enteral feeding. The objective of this study was to determine whether high proportions (≥50%) of human milk during feeding advancement are associated with shorter time to full enteral feeding and improved feeding tolerance.

METHODS. This was a prospective cohort study of very low birth weight infants (n = 127) who were grouped into low (<50%; n = 34) and high (≥50%; n = 93) human milk consumption groups according to their human milk proportion of enteral feeding during the time of feeding advancement. The primary outcomes of interest were ages at which 100 and 150 mL/kg per day enteral feedings were achieved.

RESULTS. The high human milk group reached 100 mL/kg per day enteral feeding 4.5 days faster than the low human milk group. The high human milk group reached 150 mL/kg per day enteral feeding 5 days faster than the low human milk group. After adjustment for gestational age, gender, and respiratory distress syndrome, times to reach 100 and 150 mL/kg per day were significantly shorter for those in the high human milk group. Infants in the high human milk group had a greater number of stools per day; other indicators of feeding tolerance were not statistically different.

CONCLUSION. In infants who weighed ≤1250 g, enteral feeding that contained at least 50% maternal human milk was associated with fewer days to full enteral feedings.

Key Words: human milk • enteral feeding • prematurity • very low birth weight

Abbreviations: VLBW—very low birth weight • HM—human milk • GA—gestational age • HMF—human milk fortifier • NPO—nothing by mouth • RDS—respiratory distress syndrome • NEC—necrotizing enterocolitis • HHM—high human milk • LHM—low human milk • HR—hazard ratio • CI—confidence interval

Accepted Dec 13, 2007.


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