Persistent Beneficial Effects of Breast Milk Ingested in the Neonatal Intensive Care Unit on Outcomes of Extremely Low Birth Weight Infants at 30 Months of Age
BACKGROUND. We previously reported beneficial effects of breast milk ingestion by infants with extremely low birth weight in the NICU on developmental outcomes at 18 months’ corrected age. The objective of this study was to determine whether these effects of breast milk in infants with extremely low birth weight persisted at 30 months’ corrected age.METHODS. Nutrition data, including enteral and parenteral feeds, were prospectively collected, and 30 months’ corrected age follow-up assessments were completed on 773 infants with extremely low birth weight who participated in the National Institute of Child Health and Human Development Neonatal Research Network Glutamine Trial. A total of 593 ingested some breast milk during the neonatal hospitalization, and 180 ingested none. Neonatal feeding characteristics and morbidities and 30-month interim history, neurodevelopmental outcomes, and growth parameters were analyzed. Children were divided into quintiles of breast milk volume to evaluate the effects of volume of human milk ingested during the NICU hospitalization.RESULTS. At 30 months, increased ingestion of breast milk was associated with higher Bayley Mental Developmental Index scores, higher Bayley behavior score percentiles for emotional regulation, and fewer rehospitalizations between discharge and 30 months. There were no differences in growth parameters or cerebral palsy. For every 10 mL/kg per day increase in breast milk, the Mental Developmental Index increased by 0.59 points, the Psychomotor Developmental Index by 0.56 points, and the total behavior percentile score by 0.99 points, and the risk of rehospitalization between discharge and 30 months decreased by 5%.CONCLUSIONS. Beneficial effects of ingestion of breast milk in the NICU persist at 30 months’ corrected age in this vulnerable extremely low birth weight population. Continued efforts must be made to offer breast milk to all extremely low birth weight infants both in the NICU and after discharge.
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机译：背景。我们先前曾报道过新生儿重症监护病房（NICU）中出生体重极低的婴儿摄入母乳对18个月校正年龄的发育结局具有有益作用。这项研究的目的是确定出生体重极低的婴儿在校正后的30个月内是否持续存在这些影响。前瞻性地收集了包括肠内和肠胃外营养在内的营养数据，并对参加美国国家儿童健康与人类发展研究所新生儿研究网络的谷氨酰胺试验的773例极低体重婴儿进行了30个月的校正年龄随访评估。 。新生儿住院期间，共有593人摄入了一些母乳，其中180人没有摄入。分析了新生儿的喂养特征和发病率以及30个月的中期病史，神经发育结局和生长参数。将儿童分为母乳量的五分位数，以评估NICU住院期间摄入的母乳量的影响。在30个月时，母乳摄入量增加与更高的Bayley心理发育指数得分，更高的Bayley行为得分百分位数（用于情绪调节）和出院至30个月之间的再次住院减少相关。生长参数或脑瘫无差异。母乳每天增加10 mL / kg，精神发育指数增加0.59点，精神运动发育指数增加0.56点，总行为百分点得分增加0.99点，并且出院至30个月之间再次住院的风险下降了5％。结论。在这个脆弱的极低出生体重人群中，在校正后的30个月时，新生儿重症监护病房（NICU）摄入母乳的益处仍然存在。在NICU和出院后，必须继续努力为所有极低出生体重的婴儿提供母乳。
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