An Exclusively Human Milk-Based Diet Is Associated with a Lower Rate of Necrotizing Enterocolitis than a Diet of Human Milk and Bovine Milk-Based Products

Sandra Sullivan, Richard J. Schanler, Jae H. Kim, Aloka L. Patel, Rudolf Trawöger, Ursula Kiechl-Kohlendorfer, Gary M. Chan, Cynthia Blanco, Steven Abrams, C. Michael Cotten, Nirupama Laroia, Richard A. Ehrenkranz, Golde Dudell, Elizabeth A. Cristofalo, Paula Meier, Martin L. Lee, David J. Rechtman, Alan Lucas

Research output: Contribution to journalArticle

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Abstract

Objective: To evaluate the health benefits of an exclusively human milk-based diet compared with a diet of both human milk and bovine milk-based products in extremely premature infants. Study design: Infants fed their own mothers' milk were randomized to 1 of 3 study groups. Groups HM100 and HM40 received pasteurized donor human milk-based human milk fortifier when the enteral intake was 100 and 40 mL/kg/d, respectively, and both groups received pasteurized donor human milk if no mother's milk was available. Group BOV received bovine milk-based human milk fortifier when the enteral intake was 100 mL/kg/d and preterm formula if no mother's milk was available. Outcomes included duration of parenteral nutrition, morbidity, and growth. Results: The 3 groups (total n = 207 infants) had similar baseline demographic variables, duration of parenteral nutrition, rates of late-onset sepsis, and growth. The groups receiving an exclusively human milk diet had significantly lower rates of necrotizing enterocolitis (NEC; P = .02) and NEC requiring surgical intervention (P = .007). Conclusions: For extremely premature infants, an exclusively human milk-based diet is associated with significantly lower rates of NEC and surgical NEC when compared with a mother's milk-based diet that also includes bovine milk-based products.

Original languageEnglish (US)
JournalJournal of Pediatrics
Volume156
Issue number4
DOIs
StatePublished - Apr 2010

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Necrotizing Enterocolitis
Human Milk
Milk
Diet
Extremely Premature Infants
Mothers
Parenteral Nutrition
Small Intestine
Tissue Donors
Insurance Benefits
Growth
Sepsis
Demography
Morbidity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

An Exclusively Human Milk-Based Diet Is Associated with a Lower Rate of Necrotizing Enterocolitis than a Diet of Human Milk and Bovine Milk-Based Products. / Sullivan, Sandra; Schanler, Richard J.; Kim, Jae H.; Patel, Aloka L.; Trawöger, Rudolf; Kiechl-Kohlendorfer, Ursula; Chan, Gary M.; Blanco, Cynthia; Abrams, Steven; Cotten, C. Michael; Laroia, Nirupama; Ehrenkranz, Richard A.; Dudell, Golde; Cristofalo, Elizabeth A.; Meier, Paula; Lee, Martin L.; Rechtman, David J.; Lucas, Alan.

In: Journal of Pediatrics, Vol. 156, No. 4, 04.2010.

Research output: Contribution to journalArticle

Sullivan, S, Schanler, RJ, Kim, JH, Patel, AL, Trawöger, R, Kiechl-Kohlendorfer, U, Chan, GM, Blanco, C, Abrams, S, Cotten, CM, Laroia, N, Ehrenkranz, RA, Dudell, G, Cristofalo, EA, Meier, P, Lee, ML, Rechtman, DJ & Lucas, A 2010, 'An Exclusively Human Milk-Based Diet Is Associated with a Lower Rate of Necrotizing Enterocolitis than a Diet of Human Milk and Bovine Milk-Based Products', Journal of Pediatrics, vol. 156, no. 4. https://doi.org/10.1016/j.jpeds.2009.10.040
Sullivan, Sandra ; Schanler, Richard J. ; Kim, Jae H. ; Patel, Aloka L. ; Trawöger, Rudolf ; Kiechl-Kohlendorfer, Ursula ; Chan, Gary M. ; Blanco, Cynthia ; Abrams, Steven ; Cotten, C. Michael ; Laroia, Nirupama ; Ehrenkranz, Richard A. ; Dudell, Golde ; Cristofalo, Elizabeth A. ; Meier, Paula ; Lee, Martin L. ; Rechtman, David J. ; Lucas, Alan. / An Exclusively Human Milk-Based Diet Is Associated with a Lower Rate of Necrotizing Enterocolitis than a Diet of Human Milk and Bovine Milk-Based Products. In: Journal of Pediatrics. 2010 ; Vol. 156, No. 4.
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abstract = "Objective: To evaluate the health benefits of an exclusively human milk-based diet compared with a diet of both human milk and bovine milk-based products in extremely premature infants. Study design: Infants fed their own mothers' milk were randomized to 1 of 3 study groups. Groups HM100 and HM40 received pasteurized donor human milk-based human milk fortifier when the enteral intake was 100 and 40 mL/kg/d, respectively, and both groups received pasteurized donor human milk if no mother's milk was available. Group BOV received bovine milk-based human milk fortifier when the enteral intake was 100 mL/kg/d and preterm formula if no mother's milk was available. Outcomes included duration of parenteral nutrition, morbidity, and growth. Results: The 3 groups (total n = 207 infants) had similar baseline demographic variables, duration of parenteral nutrition, rates of late-onset sepsis, and growth. The groups receiving an exclusively human milk diet had significantly lower rates of necrotizing enterocolitis (NEC; P = .02) and NEC requiring surgical intervention (P = .007). Conclusions: For extremely premature infants, an exclusively human milk-based diet is associated with significantly lower rates of NEC and surgical NEC when compared with a mother's milk-based diet that also includes bovine milk-based products.",
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AU - Schanler, Richard J.

AU - Kim, Jae H.

AU - Patel, Aloka L.

AU - Trawöger, Rudolf

AU - Kiechl-Kohlendorfer, Ursula

AU - Chan, Gary M.

AU - Blanco, Cynthia

AU - Abrams, Steven

AU - Cotten, C. Michael

AU - Laroia, Nirupama

AU - Ehrenkranz, Richard A.

AU - Dudell, Golde

AU - Cristofalo, Elizabeth A.

AU - Meier, Paula

AU - Lee, Martin L.

AU - Rechtman, David J.

AU - Lucas, Alan

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N2 - Objective: To evaluate the health benefits of an exclusively human milk-based diet compared with a diet of both human milk and bovine milk-based products in extremely premature infants. Study design: Infants fed their own mothers' milk were randomized to 1 of 3 study groups. Groups HM100 and HM40 received pasteurized donor human milk-based human milk fortifier when the enteral intake was 100 and 40 mL/kg/d, respectively, and both groups received pasteurized donor human milk if no mother's milk was available. Group BOV received bovine milk-based human milk fortifier when the enteral intake was 100 mL/kg/d and preterm formula if no mother's milk was available. Outcomes included duration of parenteral nutrition, morbidity, and growth. Results: The 3 groups (total n = 207 infants) had similar baseline demographic variables, duration of parenteral nutrition, rates of late-onset sepsis, and growth. The groups receiving an exclusively human milk diet had significantly lower rates of necrotizing enterocolitis (NEC; P = .02) and NEC requiring surgical intervention (P = .007). Conclusions: For extremely premature infants, an exclusively human milk-based diet is associated with significantly lower rates of NEC and surgical NEC when compared with a mother's milk-based diet that also includes bovine milk-based products.

AB - Objective: To evaluate the health benefits of an exclusively human milk-based diet compared with a diet of both human milk and bovine milk-based products in extremely premature infants. Study design: Infants fed their own mothers' milk were randomized to 1 of 3 study groups. Groups HM100 and HM40 received pasteurized donor human milk-based human milk fortifier when the enteral intake was 100 and 40 mL/kg/d, respectively, and both groups received pasteurized donor human milk if no mother's milk was available. Group BOV received bovine milk-based human milk fortifier when the enteral intake was 100 mL/kg/d and preterm formula if no mother's milk was available. Outcomes included duration of parenteral nutrition, morbidity, and growth. Results: The 3 groups (total n = 207 infants) had similar baseline demographic variables, duration of parenteral nutrition, rates of late-onset sepsis, and growth. The groups receiving an exclusively human milk diet had significantly lower rates of necrotizing enterocolitis (NEC; P = .02) and NEC requiring surgical intervention (P = .007). Conclusions: For extremely premature infants, an exclusively human milk-based diet is associated with significantly lower rates of NEC and surgical NEC when compared with a mother's milk-based diet that also includes bovine milk-based products.

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