Growth and Development in Extremely Low Birth Weight Infants After the Introduction of Exclusive Human Milk Feedings

Abstract

<b>Objective</b> To estimate associations of exclusive human milk (EHM) feedings with growth and neurodevelopment through 18 months corrected age (CA) in extremely low birth weight (ELBW) infants. <b>Study Design</b> ELBW infants admitted from July 2011 to June 2013 who survived were reviewed. Infants managed from July 2011 to June 2012 were fed with bovine milk-based fortifiers and formula (BOV). Beginning in July 2012, initial feedings used a human milk-based fortifier to provide EHM feedings. Infants were grouped on the basis of feeding regimen. Primary outcomes were the Bayley-III cognitive scores at 6, 12, and 18 months and growth. <b>Results</b> Infants (<i>n</i> = 85; 46% received EHM) were born at 26 ± 1.9 weeks (<i>p</i> = 0.92 between groups) weighing 776 ± 139 g (<i>p</i> = 0.67 between groups). Cognitive domain scores were similar at 6 months (BOV: 96 ± 7; EHM: 95 ± 14; <i>p</i> = 0.70), 12 months (BOV: 97 ± 10; EHM: 98 ± 9; <i>p</i> = 0.86), and 18 months (BOV: 97 ± 16; EHM: 98 ± 14; <i>p</i> = 0.71) CA. Growth velocity prior to discharge (BOV: 12.1 ± 5.2 g/kg/day; EHM: 13.1 ± 4.0 g/kg/day; <i>p</i> = 0.33) and subsequent growth was similar between groups. <b>Conclusion</b> EHM feedings appear to support similar growth and neurodevelopment in ELBW infants as compared with feedings containing primarily bovine milk-based products.