Comparison of types of breast milk fortification at discharge from the neonatal intensive care unit and breast milk feeding rates and growth at 4 months corrected age

Brigitta Gehl, Elizabeth Brownell, Kimberly Power, Richard Feinn, Kathleen Haines, Mary Lussier, James Moore, Shabnam Lainwala

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Effects of breast milk (BM) enhancement on long-term BM feeding in preterm infants discharged from the neonatal intensive care unit (NICU) have not been examined previously. This study compares any BM feeding rates at 4 months corrected age (CA) in preterm infants discharged from the NICU on BM enhancement by fortification of expressed BM with infant formula additives (BM-F) versus BM supplemented with infant formula feeds (BM-S). Subjects and Methods: We compared infants born between January 1, 2013, and December 31, 2017, with gestational age <32 weeks or birth weight <1500 g, discharged home on BM-F or BM-S from two NICUs and followed at 4 months CA. Multivariate logistic regression with propensity scoring estimated the adjusted associations between nutrition at discharge and any BM feeding at 4 months CA. Results: Two hundred eighty-five infants were followed at 4 months CA. Infants discharged on BM-F were more likely to have mothers with multiple gestation, private insurance and not Caucasian, initiate feeds of human milk, be discharged from NICU-1, and receive any BM at 4 months CA ( p < 0.03). No significant difference in growth parameters <10th percentile at 4 months CA was observed between the two groups. After adjusting for confounding factors, discharge from the NICU on BM-F was significantly associated with BM feeding at 4 months CA (odds ratio: 3.89, 95% confidence interval 1.66-9.14, p = 0.002). Conclusion: In this observational study, preterm infants receiving BM fortified with formula powder additives at discharge from the NICU had better BM feeding outcomes without poor growth at 4 months CA relative to those infants receiving BM supplemented with infant formula feeds.

Original languageEnglish (US)
Pages (from-to)655-661
Number of pages7
JournalBreastfeeding Medicine
Volume15
Issue number10
DOIs
StatePublished - Oct 2020

Keywords

  • Breast milk
  • Feeding
  • Fortification
  • Nutrition
  • Postdischarge
  • Preterm infant

ASJC Scopus subject areas

  • Pediatrics
  • Health Policy
  • Obstetrics and Gynecology
  • Maternity and Midwifery

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