The efficacy of fortified human milk compared to human milk alone for the growth of low birth weight infants
Keywords:
low birth weight infants, human milk, human milk fortifier, growth
Abstract
Objective To evaluate the growth of low birth weight infants fedby fortified human milk (FHM) compared to human milk (HM) alone.
Methods Sixty premature infants enrolled in this study and ran-
domly assigned to have FHM and HM delivered by infusofeedpump,
in parallel, non-blinded controlled trial. All patients were followed
until day 30 or until discharge, whichever came first. The weight
gain was recorded daily, while length and head circumference in-
crement were recorded weekly.
Results The FHM group gained more weight than the HM group
(335.0+55.5 g vs. 290.6+108.4 g, p=0.000, 95%CI -170.2;-81.2),
larger length increment (1.9+1.1cm vs. 1.2+0.4cm, p=0.000, 95%CI
-1.37;-0.55), and larger head increment (1.87+1.1cm vs.
0.91+0.43cm, 95%CI -1.37;-0.55). A similar result was found when
the group was divided into subgroup of 1000-1499 g and 1500-
1999 g birth weight. The larger calorie intake in the FHM group
was the reason for better growth. No adverse effect related to the
intervention was found.
Conclusion The study shows the benefit of FHM in growth of low
birth weight infants, which is consistent when the group is divided
into 1000-1499 g birth weight and 1500-1999 g birth weight sub
groups. Better growth is achieved through higher calorie intake in
the FHM group. No adverse effect is found as a consequence of
intervention
References
1. Rahmat ES. Masalah dan faktor risiko bayi BBLR di
Puskesmas Karangasem, Pemalang. Medika 1996;
9:718-20
2. Setyowati T, Soesanto SS, Budioarso LR, Kristanti,
Djaja S, Ma’roef S. Faktor-faktor yang mempengaruhi
bayi lahir dengan berat badan rendah (Analisis lanjut
SKDI, 1994). Bul Penelit Kesehat 1996;24:38-54
3. Hamid A, Hendra S, Lila N. Hubungan antara kadar
prealbumin serum bayi berat lahir rendah dengan kadar
prealbumin serum ibu di RSUP Denpasar. Majalah
Kedokteran Udayana 1994;84:78-81
4. Soetjiningsih. Tumbuh kembang bayi berat lahir
rendah. Presented at the Wyeth S-26/SMA HMF 1999
Symposium of tumbuh kembang BBLR & human milk
fortifier; 1999 Aug 7; Denpasar, Indonesia.
5. Barten J. Kematian perinatal di Rumah Sakit Gunung
Maria Tomohon, Sulawesi Utara. Analisis 355 kasus.
Medika 1992:19-24
6. Kornia K, Arsana W. Kematian perinatal di RSUP
Denpasar 1990-1991. Majalah Kedokteran Udayana
1995;89:147-151
7. Monintja HE. Beberapa aspek kebutuhan bayi
kurang bulan. In: Suradi R, Monintja HE, Amalia P,
Kusumowardhani D, editors. Naskah lengkap
pendidikan kedokteran berkelanjutan ilmu
kesehatan anak XXXVIII. Jakarta: Balai Penerbit
FK UI; 1997
8. Greer FR, McCormick AM. Improved bone mineral-
ization and growth in premature infants fed fortified
own mother’s milk. J Pediatr 1988;112:961-1
9. Schanler RJ, Garza C, Nichols BL. Fortified mother’s
milk for very low birth weight infants: results of
growth and nutrient balance studies. J Pediatr
1985;103:437-45
10. Monintja HE. Masalah-masalah nutrisi enteral pada
bayi kurang bulan. Proceedings of the Wyeth S-26/
SMA HMF 1999 Symposium.of tumbuh kembang
BBLR & human milk fortifier; 1999 Aug 7; Denpasar,
Indonesia
11. Gultom E. Segi praktis nutrisi enteral bayi kurang
bulan. Proceedings of the Wyeth S-26/SMA HMF 1999
Symposium.of tumbuh kembang BBLR & human milk
fortifier; 1999 Aug 7; Denpasar, Indonesia
12. Suradi R. Keuntungan pemberian ASI untuk bayi pre-
mature (kurang bulan). In: Suradi R, Monintja HE,
Amalia P, Kusumowardhani D, editors. Naskah lengkap
pendidikan kedokteran berkelanjutan ilmu kesehatan
anak XXXVIII; 1997 April 7-8; Jakarta: Balai Penerbit
FKUI; 1997
13. Hamid A. Prematuritas dan air susu ibu. In :
Soetjiningsih, editor. ASI: petunjuk untuk tenaga
kesehatan. Jakarta: EGC;1997. p. 59-60
14. Soetjiningsih. Peran air susu ibu dalam pencegahan dan
penatalaksanaan diare akut. In: Soetjiningsih, editor.
ASI: Petunjuk untuk tenaga kesehatan..Jakarta;
EGC;1997. p.65-74
15. Soetjiningsih. Peran asam lemak esensial pada
pertumbuhan otak anak. Presented in round table
discussion PT Wyeth Indonesia; 2002 Apr 6;
Denpasar, Indonesia.
16. Hay WW, Lucas A, Heird WC, Ziegler E, Levin E,
Grave GD, et al. Workshop summary: nutrition of the
extremely low birth weight infant. Pediatrics
1999;104:1360-8
17. Hall RT. Composition of Human Milk. Pediatr Clin
of North America. Available from: URL: http://
www.mdconsult.com
18. Hall RT. Caroll RS. Infant feeding. Pediatr in Re-
view 2000;21. Available from: URL : http://
www.mdconsult.com
19. Picciano MF. The evidence for breastfeeding. Nu-
trient composition of human milk. Pediatr Clin of
North America 2001;48. Available from: URL: http:/
/www.mdconsult.com
20. Schanler RJ. The use of human milk for premature
infants. Pediatr Clin of North America 2001;48.
Available from: URL: http://www.mdconsult.com
21. Schanler RJ, Shulman RJ, Lau C. Feeding strategies
for premature infants: beneficial outcomes of feeding
fortified human milk versus preterm formula. Pediat-
rics 1999;103:1150-1156
22. McCain GC. A feeding protocol for healthy preterm
infants that shortens time to oral feeding. J of
Pediatr 2001; 139 Available from: URL: http://
www.mdConsult.com
23. Padmi IA. Manajemen laktasi. In: Soetjiningsih, edi-
tor. ASI: petunjuk untuk tenaga kesehatan. Jakarta:
EGC;1997. p. 89-90
24. Stone DG, Forbes D, Hill R, Mikola D, Elgoni A, Boyd
D, et al. A New method for provision of enteral tube
feeds. Proceedings of The XV International Conference
of Nutrition;1993 Sept 20-Oct 1; Adelaide, Australia.
25. Berry MA, Abrahamowics M, Usher RH. Factors as-
sociated with growth in extremely low birth weight
infants during initial hospitalization. Pediatrics
1997;100:640-6
26. Berry MA, Conrod H, Usher RH. Growth of very
premature infants fed intravenous hyperalimentation
and calcium supplemented formula. Pediatrics
1997;100:647-653
27. O’Connor DL, Hall R, Adamkins, Auestad N, Castillo
M, E Connor W, et al. Growth and development in
preterm infants fed long chain polyunsaturated fatty
acids: a prospective, randomized controlled trial. Pedi-
atrics 2001;108:359-71
28. Innis SM, Adamkin DH, Hall RT, Kalhan SC, Lair C,
Lim M, et al. Docosahexaenoic acid and arachidonic
acid enhance growth with no adverse effects in preterm
infants fed formula. J Pediatr 2002; 140. Available from:
URL: http://www.mdconsult.com
29. S26/SMA Human Milk Fortifier. Manual Wyeth
Nutritionals International.
30. Ernasari. S26/SMA human milk fortifier. Presented in
Wyeth S26/SMA HMF 1999 Symposium. Tumbuh
kembang BBLR & human milk fortifier; 1999 Aug 7;
Denpasar, Indonesia.
31. Thureen PJ. Early aggressive nutrition in neonate. Pe-
diatrics in Review 1999;20:e45-55
32. Berseth CL. Minimal enteral feedings. Clinics in
Perinatology 1995;22:195-205
33. Slagle TA, Gross SJ. Effect of early low volume enteral
substrate on subsequent feeding tolerance in very low
birth weight infants. J Pediatr 1988;113:526-31
34. Berseth CL. Neonatal small intestinal motility: motor
responses to feeding in term and preterm infants. J
Pediatr 1990;117:777-82
35. Lebenthal E. Gastrointestinal maturation and motil-
ity pattern as indicators for feeding the premature in-
fant. Pediatrics 1995;95:207-9
36. Silvestre MAA, Morbach CA, Brans YW, Shankaran
S. A prospective randomised trial; comparing continu-
ous versus intermittent feeding methods in very low
birth weight neonates. J Ped 1996;128:48-52
37. Berseth CL. Effect of early feeding on maturation of
the preterm infant’s small intestine. J Pediatr
1992;120:947-53
38. Embleton NE, Pang N, Cooke RJ. Postnatal malnutri-
tion and growth retardation: an inevitable consequence
of current recommendations in preterm infants? Pedi-
atrics 2001;107:270-3
Puskesmas Karangasem, Pemalang. Medika 1996;
9:718-20
2. Setyowati T, Soesanto SS, Budioarso LR, Kristanti,
Djaja S, Ma’roef S. Faktor-faktor yang mempengaruhi
bayi lahir dengan berat badan rendah (Analisis lanjut
SKDI, 1994). Bul Penelit Kesehat 1996;24:38-54
3. Hamid A, Hendra S, Lila N. Hubungan antara kadar
prealbumin serum bayi berat lahir rendah dengan kadar
prealbumin serum ibu di RSUP Denpasar. Majalah
Kedokteran Udayana 1994;84:78-81
4. Soetjiningsih. Tumbuh kembang bayi berat lahir
rendah. Presented at the Wyeth S-26/SMA HMF 1999
Symposium of tumbuh kembang BBLR & human milk
fortifier; 1999 Aug 7; Denpasar, Indonesia.
5. Barten J. Kematian perinatal di Rumah Sakit Gunung
Maria Tomohon, Sulawesi Utara. Analisis 355 kasus.
Medika 1992:19-24
6. Kornia K, Arsana W. Kematian perinatal di RSUP
Denpasar 1990-1991. Majalah Kedokteran Udayana
1995;89:147-151
7. Monintja HE. Beberapa aspek kebutuhan bayi
kurang bulan. In: Suradi R, Monintja HE, Amalia P,
Kusumowardhani D, editors. Naskah lengkap
pendidikan kedokteran berkelanjutan ilmu
kesehatan anak XXXVIII. Jakarta: Balai Penerbit
FK UI; 1997
8. Greer FR, McCormick AM. Improved bone mineral-
ization and growth in premature infants fed fortified
own mother’s milk. J Pediatr 1988;112:961-1
9. Schanler RJ, Garza C, Nichols BL. Fortified mother’s
milk for very low birth weight infants: results of
growth and nutrient balance studies. J Pediatr
1985;103:437-45
10. Monintja HE. Masalah-masalah nutrisi enteral pada
bayi kurang bulan. Proceedings of the Wyeth S-26/
SMA HMF 1999 Symposium.of tumbuh kembang
BBLR & human milk fortifier; 1999 Aug 7; Denpasar,
Indonesia
11. Gultom E. Segi praktis nutrisi enteral bayi kurang
bulan. Proceedings of the Wyeth S-26/SMA HMF 1999
Symposium.of tumbuh kembang BBLR & human milk
fortifier; 1999 Aug 7; Denpasar, Indonesia
12. Suradi R. Keuntungan pemberian ASI untuk bayi pre-
mature (kurang bulan). In: Suradi R, Monintja HE,
Amalia P, Kusumowardhani D, editors. Naskah lengkap
pendidikan kedokteran berkelanjutan ilmu kesehatan
anak XXXVIII; 1997 April 7-8; Jakarta: Balai Penerbit
FKUI; 1997
13. Hamid A. Prematuritas dan air susu ibu. In :
Soetjiningsih, editor. ASI: petunjuk untuk tenaga
kesehatan. Jakarta: EGC;1997. p. 59-60
14. Soetjiningsih. Peran air susu ibu dalam pencegahan dan
penatalaksanaan diare akut. In: Soetjiningsih, editor.
ASI: Petunjuk untuk tenaga kesehatan..Jakarta;
EGC;1997. p.65-74
15. Soetjiningsih. Peran asam lemak esensial pada
pertumbuhan otak anak. Presented in round table
discussion PT Wyeth Indonesia; 2002 Apr 6;
Denpasar, Indonesia.
16. Hay WW, Lucas A, Heird WC, Ziegler E, Levin E,
Grave GD, et al. Workshop summary: nutrition of the
extremely low birth weight infant. Pediatrics
1999;104:1360-8
17. Hall RT. Composition of Human Milk. Pediatr Clin
of North America. Available from: URL: http://
www.mdconsult.com
18. Hall RT. Caroll RS. Infant feeding. Pediatr in Re-
view 2000;21. Available from: URL : http://
www.mdconsult.com
19. Picciano MF. The evidence for breastfeeding. Nu-
trient composition of human milk. Pediatr Clin of
North America 2001;48. Available from: URL: http:/
/www.mdconsult.com
20. Schanler RJ. The use of human milk for premature
infants. Pediatr Clin of North America 2001;48.
Available from: URL: http://www.mdconsult.com
21. Schanler RJ, Shulman RJ, Lau C. Feeding strategies
for premature infants: beneficial outcomes of feeding
fortified human milk versus preterm formula. Pediat-
rics 1999;103:1150-1156
22. McCain GC. A feeding protocol for healthy preterm
infants that shortens time to oral feeding. J of
Pediatr 2001; 139 Available from: URL: http://
www.mdConsult.com
23. Padmi IA. Manajemen laktasi. In: Soetjiningsih, edi-
tor. ASI: petunjuk untuk tenaga kesehatan. Jakarta:
EGC;1997. p. 89-90
24. Stone DG, Forbes D, Hill R, Mikola D, Elgoni A, Boyd
D, et al. A New method for provision of enteral tube
feeds. Proceedings of The XV International Conference
of Nutrition;1993 Sept 20-Oct 1; Adelaide, Australia.
25. Berry MA, Abrahamowics M, Usher RH. Factors as-
sociated with growth in extremely low birth weight
infants during initial hospitalization. Pediatrics
1997;100:640-6
26. Berry MA, Conrod H, Usher RH. Growth of very
premature infants fed intravenous hyperalimentation
and calcium supplemented formula. Pediatrics
1997;100:647-653
27. O’Connor DL, Hall R, Adamkins, Auestad N, Castillo
M, E Connor W, et al. Growth and development in
preterm infants fed long chain polyunsaturated fatty
acids: a prospective, randomized controlled trial. Pedi-
atrics 2001;108:359-71
28. Innis SM, Adamkin DH, Hall RT, Kalhan SC, Lair C,
Lim M, et al. Docosahexaenoic acid and arachidonic
acid enhance growth with no adverse effects in preterm
infants fed formula. J Pediatr 2002; 140. Available from:
URL: http://www.mdconsult.com
29. S26/SMA Human Milk Fortifier. Manual Wyeth
Nutritionals International.
30. Ernasari. S26/SMA human milk fortifier. Presented in
Wyeth S26/SMA HMF 1999 Symposium. Tumbuh
kembang BBLR & human milk fortifier; 1999 Aug 7;
Denpasar, Indonesia.
31. Thureen PJ. Early aggressive nutrition in neonate. Pe-
diatrics in Review 1999;20:e45-55
32. Berseth CL. Minimal enteral feedings. Clinics in
Perinatology 1995;22:195-205
33. Slagle TA, Gross SJ. Effect of early low volume enteral
substrate on subsequent feeding tolerance in very low
birth weight infants. J Pediatr 1988;113:526-31
34. Berseth CL. Neonatal small intestinal motility: motor
responses to feeding in term and preterm infants. J
Pediatr 1990;117:777-82
35. Lebenthal E. Gastrointestinal maturation and motil-
ity pattern as indicators for feeding the premature in-
fant. Pediatrics 1995;95:207-9
36. Silvestre MAA, Morbach CA, Brans YW, Shankaran
S. A prospective randomised trial; comparing continu-
ous versus intermittent feeding methods in very low
birth weight neonates. J Ped 1996;128:48-52
37. Berseth CL. Effect of early feeding on maturation of
the preterm infant’s small intestine. J Pediatr
1992;120:947-53
38. Embleton NE, Pang N, Cooke RJ. Postnatal malnutri-
tion and growth retardation: an inevitable consequence
of current recommendations in preterm infants? Pedi-
atrics 2001;107:270-3
Published
2016-09-26
How to Cite
1.
Ketut D, Soetjiningsih S, IKG S, A H. The efficacy of fortified human milk compared to human milk alone for the growth of low birth weight infants. PI [Internet]. 26Sep.2016 [cited 19Apr.2024];43(5):177-5. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/689
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Received 2016-09-24
Accepted 2016-09-24
Published 2016-09-26
Accepted 2016-09-24
Published 2016-09-26
