Abstract
Background
Late and moderate preterm (LMPT) infants are at risk for adverse later life outcomes. We determined the association between feeding method at enrolment and growth and body composition of LMPT infants until 3 months corrected age (3mCA).
Methods
Infants born between 32+0 and 36+6 weeks of gestation (n = 107) were enrolled up to 4 weeks corrected age and stratified according to feeding at enrolment. We performed anthropometric measurements at enrolment, term equivalent age (TEA) and 3mCA, including skinfold measurements and body composition using dual X-ray absorptiometry (DEXA).
Results
Feeding method at enrolment was associated with fat mass (FM) (breast 554.9 g, mixed 716.8 g, formula 637.7 g, p = 0.048), lean body mass (LM) (2512 g, 2853 g, 2722 g, respectively, p = 0.009) and lean mass index (LMI) (10.6 kg/m2, 11.6 kg/m2,11.2 kg/m2 respectively, p = 0.008) at TEA, but not 3mCA. Breastfed infants demonstrated greater increase in LM (breast 1707 g, mixed 1536 g, formula 1384 g, p = 0.03) and LMI (1.23 kg/m2, 0.10 kg/m2, 0.52 kg/m2, respectively, p = 0.022) between TEA and 3mCA.
Conclusions
Breastfed LMPT infants have lower FM and greater LM increase and LMI increase up to 3mCA compared to formula or mixed-fed infants. These findings stress the importance of supporting breastfeeding in this population.
Impact
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Infants born late and moderate preterm age who are exclusively breastfed soon after birth gain more lean mass up to 3 months corrected age compared to mixed- or formula-fed infants.
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Breastfed infants have lower lean and fat mass at term equivalent age compared to mixed- and formula-fed infants.
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This is the first study exploring this population’s growth and body composition in detail at 3 months corrected age.
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Our results underline the importance of supporting mothers to initiate and continue breastfeeding at least until 3 months corrected age.
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Data availability
The data sets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
We are very thankful to the Research Nursing staff of the Royal Victoria Infirmary for assisting with the enrolment and data collection for the study. The data analysis was performed by independent statisticians who have no conflict of interest to declare.
Funding
This research was funded by Danone Nutricia Research via an Investigator Led Clinical Research Funding award to Newcastle Hospitals NHS Foundation Trust.
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Contributions
M.A.-B., N.D.E. and R.M.v.E. concepted and designed the study. A.K., J.E.B. and N.D.E. acquired data. L.H. and R.J.Q.M.N. performed the statistical analysis and interpretation was done by all authors. A.K., M.A.-B., N.D.E., R.M.v.E. and J.E.B. drafted the article. All authors took part revising the paper. A.K., M.A.-B., N.D.E. and R.M.v.E. had primary responsibility for the final content. All authors read and approved the final version of manuscript.
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Competing interests
M.A.-B. is an employee of Danone Nutricia Research. R.M.v.E. was an employee of Danone Nutricia Research during conduct of this study. N.D.E. and J.E.B. declare research funding from Danone Early Life Nutrition and Prolacta Biosciences US and lecture honoraria from Nestle Nutrition Institute. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Ethics approval and consent to participate
The study was reviewed by the North East–York Research Ethics Committee, approved by the NHS Health Research Authority (IRAS project ID: 237542) and registered at ISRCTN (ISRCTN15469594). The procedures followed were in accordance with the Helsinki Declaration of 1975 as revised in 1983. Consent was sought and obtained according to the standards of ethical research. Parents of eligible infants were approached from the time of birth up to 4 weeks after term equivalent age and given a study leaflet, explained the study and answered questions and approached again at a second stage to answer questions and explore intention for consent.
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Kakaroukas, A., Abrahamse-Berkeveld, M., Hayes, L. et al. Early infancy growth, body composition and type of feeding in late and moderate preterms. Pediatr Res 93, 1927–1935 (2023). https://doi.org/10.1038/s41390-022-02317-z
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DOI: https://doi.org/10.1038/s41390-022-02317-z
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