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Growth after implementing a donor breast milk program in neonates <33 weeks gestational age or birthweight <1500 grams: Retrospective cohort study

Journal of Perinatology volume 43, pages 608–615 (2023)Cite this article

Subjects

Abstract

Background

Donor breast milk (DBM) feeding has been associated with less growth than formula in preterm infants. Zinc content in DBM is insufficient to support growth in preterm infants.

Objective

To compare growth from birth to discharge, macro- and micronutrient intake and the frequency of poor growth before (Epoch-1) and after (Epoch-2) implementing a DBM program.

Methods

Retrospective cohort study of 1069 infants born at < 33 weeks’ gestational age or birthweight < 1500 g and fed using our adjustable feeding protocol with accurate serial length measurements. Growth was assessed by changes in Z-scores of weight, length and fronto-occipital circumference from birth to discharge.

Results

Growth did not decrease significantly in Epoch-2. However, energy and protein intake increased by 5% and frequency of zinc and vitamin D supplementation increased by >30%.

Conclusions

DBM implementation did not significantly decrease growth from birth to discharge using our adjustable feeding protocol.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This study was funded by the Children’s Medical Center Clinical Advisory Committee (CCRAC) (LP Brion) and by the Department of Pediatrics at UT Southwestern Medical Center.

Author contributors

MSR conceptualized and designed the study, collected and reviewed data from the medical records and wrote the first draft of the manuscript. CL, AE, and TJ collected and reviewed data from the medical records, participated in the interpretation of the data. LPB conceptualized and designed the study, collected and reviewed data from the medical records. LPB and LSB conducted statistical analyses. PJB, PS, IK, DV, and CC, IT specialist at Parkland Hospital, extracted data from the electronic health record. All authors participated in the interpretation of the data, critically reviewed the revisions, and approved the final manuscript as submitted. We thank Mambarambath Jaleel, MD and Elen Petrosyan, RD, who were instrumental in implementing the DBM program. Aktar Ali, MS performed DBM sample analysis for copper and zinc in Dr. Orson Moe’s laboratory at UT Southwestern Medical Center. Anita Thomas, RN, helped with data collection into the resuscitation database.

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Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Mariela Sanchez-Rosado, Roy Heyne, David B. Nelson, Myra H. Wyckoff, Jordan Reis, Patti J. Burchfield, Pollienna Sepulveda & Luc P. Brion

  2. Division of Neonatology, Joe DiMaggio Children’s Hospital, Hollywood, FL, USA

    Mariela Sanchez-Rosado

  3. Parkland Hospital and Health System, Dallas, TX, USA

    Cheryl S. Lair, Audrey Edwards, Theresa Jacob, L. Steven Brown & Christopher Clark

  4. Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Texas Southwestern Medical Center, and Parkland Hospital and Health System, Dallas, TX, USA

    David B. Nelson

  5. University of Texas Southwestern Medical Center, Dallas, TX, USA

    Isabelle Kiefaber & Diksha Verma

  6. Baylor Scott & White, Dallas, TX, USA

    Jordan Reis

Authors
  1. Mariela Sanchez-Rosado
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Correspondence to Luc P. Brion.

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Sanchez-Rosado, M., Lair, C.S., Edwards, A. et al. Growth after implementing a donor breast milk program in neonates <33 weeks gestational age or birthweight <1500 grams: Retrospective cohort study. J Perinatol 43, 608–615 (2023). https://doi.org/10.1038/s41372-023-01627-2

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