Bibiana Chinea Jiménez

Objective: The main objective was to describe the impact of full oral feeding achievement in very low birth weight infants on weight, length, and head circumference, measured as the change in z-score from 32 weeks to discharge, the time at which full oral feeding occurs.Methods: This was a longitudinal retrospective observational study on infants younger than 30 weeks of gestational age, admitted to the Neonatology Unit of La Paz University Hospital, Madrid (Spain), from January 1, 2019 to December 31, 2019. The infant's anthropometric characteristics (weight, height, and head circumference) were compared at birth, at 32, 34, and 36 weeks of gestational age, at the time of full oral feeding, and at discharge from the unit.Results: A total of 66 infants were included, gestational age at birth range from 24 to 30. Full oral intake occurred at 37.1 ± 2.1 weeks postmenstrual age (PMA). We found an inverse correlation between gestational age at birth and birth weight with PMA at which full oral feeding (FOF) is achieved. PMA at discharge was 38.6 ± 2.5 weeks. Age of full oral intake and discharge occurred later in infants who had patent ductus arteriosus, retinopathy of prematurity, and sepsis or received a blood transfusion. A positive correlation was found between days of oxygen and both parameters. However, we found no relationship between necrotizing enterocolitis or intraventricular hemorrhage with age at full oral feeding or age at discharge.Conclusions: The transition from gastric tube to oral intake did not affect growth. We found a close relationship between preterm infants birth, earlier younger than 30 weeks of gestational age, and low birth weight, with a delay in full oral feeding achievement that correlated with age at discharge.

Background: Data are limited on the association between the use of donor human milk and improvements in feeding tolerance. Objective: To determine the influence of the duration of parenteral nutrition on the growth and morbidity of the breastfed newborn when using donated human milk in the absence of mother’s own milk. Methods: We conducted a retrospective study before and after the intervention that compared two groups of newborns ( N = 284; each group n = 142). We used a convenience sample of all newborns ≤32 weeks gestation consecutively admitted in a single unit before (Group 1 between December 2012 and May 2014) or after (Group 2 between October 2014 and December 2016) the availability of donor human milk. In Group 2, donor human milk was administered at least 3 to 4 weeks or until the baby weighed 1,500 g. Weight was recorded daily and length and head circumference weekly. Parenteral nutrition was continued until enteral feeding volume reached 120 ml/kg/day. Additional variables measured were the number of days with a central venous catheter, age that the enteral feeding volume reached 150 ml/kg/day, and duration of stay. Results: The duration of parenteral feeding was the same before and after: 12 (8.23) and 11 (7.19) days ( p = .822). The z scores for weight and height of newborns was lower in Group 2 = −1.8 (1.0) and −2.3 (1.1) and Group 1 = −1.2 (1.1) ( p < .001) and −1.8 (1.4) ( p = .005). Conclusion: We did not find an association between the administration of donor human milk as a supplement to mother’s own milk and reduced number of days of parenteral nutrition. Back translation by Laurence Grummer-Strawn

Introducción: Los objetivos del presente estudio son evaluar el efecto de la alimentación con leche materna durante las primeras semanas de vida en los recién nacidos de muy bajo peso sobre: la ganancia ponderal en el momento del alta, la duración de la estancia hospitalaria, la edad postmenstrual al alta y el estado nutricional, crecimiento y neurodesarrollo a los dos y cinco años.Material y métodos: Estudio longitudinal de recién nacidos de muy bajo peso al nacer (<1500 gramos), ingresados en la Unidad de Cuidados Intensivos Neonatales del Hospital Universitario La Paz, desde el 1 de enero de 2009 al 31 de diciembre de 2009, cuyo seguimiento se está realizando en la consulta de Neonatología y sus padres aceptaron realizar un estudio antropométrico más exhaustivo a los 5 años, teniendo en cuenta la ingesta al alta de leche materna exclusiva, leche de fórmula o mixta. Se evaluó la estancia hospitalaria y la antropometría al alta. A los 2 años de edad se recogieron datos antropométricos (peso, talla y perímetro cefálico) y se realizó valoración del neurodesarrollo según la escala de Bayley II de desarrollo infantil. Los datos a los 5 años fueron recogidos prospectivamente. Se realizaron medidas de peso, talla y perímetro cefálico, perímetros de cintura, cadera, brazo relajado y contraído, muslo y pierna media, pliegues bicipital, tricipital, subescapular, suprailíaco y pierna. Para los pacientes mayores de 5 años, se utilizó la batería de evaluación de Kaufman para niños. El efecto de la ingesta de leche materna en las variables de interés se investigó usando un análisis multivariante corrigiendo por edad gestacional y peso de recién nacido.Resultados: 152 niños fueron dados de alta: leche materna exclusiva (59), leche de fórmula (55) o mixta (38). A 61 de ellos se les realizó un seguimiento mas exhaustivo. La ingesta de leche materna durante el primer ingreso disminuye la estancia hospitalaria inicial, y se asocia con mayor perímetro cefálico a los 2 y a los 5 años y mejor puntuación en el área cognitiva global y verbal a los 5 años.Conclusiones: Nuestros resultados sugieren que la alimentación con leche de la propia madre durante el ingreso inicial debe ser fomentada porque puede mejorar el neurodesarrollo a los 5 años de edad.