The impact of exclusive human milk diet on short-term growth of very preterm infants

J Perinatol. 2024 Nov;44(11):1567-1574. doi: 10.1038/s41372-024-01980-w. Epub 2024 Apr 27.

Abstract

Objectives: The impact of exclusive human milk diet (EHMD) on postnatal growth remains controversial. This study aims to investigate the association between EHMD and short-term growth.

Methods: This multicenter retrospective study aims to compare growth between the EHMD and non-EHMD groups among infants <32 weeks of gestation. Primary outcomes include weight, length, and head circumference growth trajectories between birth and 34 weeks postmenstrual age. Sensitivity and subgroup analyses were performed.

Results: An EHMD was independently associated with poorer length growth, especially in infants born at ≥28 weeks' gestation or those exposed to hypertensive disorders of pregnancy. While initiating fortification at <26 kcal/oz on an EHMD showed inferior growth, initiating fortification at ≥26 kcal/oz was associated with improved weight growth, and similar length and head circumference growth when compared to the non-EHMD group.

Conclusions: An EHMD with initial fortification at ≥26 kcal/oz may be implemented to avoid bovine milk exposure while sustaining comparable growth.

Publication types

  • Multicenter Study

MeSH terms

  • Body Height
  • Female
  • Food, Fortified*
  • Gestational Age
  • Humans
  • Infant Nutritional Physiological Phenomena
  • Infant, Extremely Premature / growth & development
  • Infant, Newborn
  • Infant, Premature / growth & development
  • Male
  • Milk, Human*
  • Pregnancy
  • Retrospective Studies