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Impact of breast milk composition on nutritional status of term neonates with congenital heart defects: A prospective study.
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Kaplina Aleksandra V, Fedoseeva Tatiana A, Pervunina Tatiana M, Kalinina Olga V, Shemyakina Olga O, Barakova Tatiana G, Kim Maria V, Petrova Natalia A
Аннотация
BACKGROUND: Congenital heart defects (CHDs) are the most common congenital malformations, often requiring surgical intervention during the early neonatal period. Although most children with CHDs are born at full term with appropriate birth weights, many of them develop malnutrition during the first weeks of life, resulting in complications after cardiac surgery. This study aimed to provide new insights into personalized nutritional interventions based on variations in breast milk (BM) composition. We hypothesized that the nutritional and energy composition of BM is associated with the growth trajectory during the late neonatal period in neonates with CHDs, and it may guide individualized nutrition support.
AIM: To assess the BM composition in mothers of neonates with CHD and evaluate its role in the nutritional status of these neonates.
METHODS: In this single-center prospective non-interventional study, we analyzed the BM composition in 35 mothers of neonates with CHDs (25 operated, 10 non-operated) at V1 (2-5 days), V2 (7-12), and V3 (14-40), and also in 21 mothers of healthy infants at V1 (n = 21) and V2 (n = 12), using the Miris Human Milk Analyzer. The weight-for-age z score (WAZ) at discharge was assessed in infants with CHD. Associations between the BM composition, nutrient intake, postoperative course, and WAZ change were evaluated.
RESULTS: Only the colostrum fat concentration was significantly lower in mothers of operated neonates [2.4 (2.0-2.6) g/100 mL] compared with mothers of non-operated neonates [2.9 (2.2-3.1) g/100 mL] and controls [2.7 (2.3-3.3) g/100 mL] (P = 0.045). Operated neonates exhibited a greater decrease in WAZ from birth to discharge than non-operated neonates (P = 0.008). Postoperative WAZ decline was associated with the postoperative period severity and delayed reintroduction of BM feeding. Higher calorie and fat intake on postoperative day 14 was significantly associated with a smaller WAZ decrease (P < 0.05). Later postoperative achievement of full enteral feeding independently predicted WAZ decline. In the operated group the colostrum protein content positively correlated with weight gain during the early neonatal period.
CONCLUSION: Colostrum from mothers of operated neonates with CHD had reduced fat content. BM composition did not affect WAZ trajectories. However, delayed achievement of full enteral feeding independently predicted WAZ decline.
AIM: To assess the BM composition in mothers of neonates with CHD and evaluate its role in the nutritional status of these neonates.
METHODS: In this single-center prospective non-interventional study, we analyzed the BM composition in 35 mothers of neonates with CHDs (25 operated, 10 non-operated) at V1 (2-5 days), V2 (7-12), and V3 (14-40), and also in 21 mothers of healthy infants at V1 (n = 21) and V2 (n = 12), using the Miris Human Milk Analyzer. The weight-for-age z score (WAZ) at discharge was assessed in infants with CHD. Associations between the BM composition, nutrient intake, postoperative course, and WAZ change were evaluated.
RESULTS: Only the colostrum fat concentration was significantly lower in mothers of operated neonates [2.4 (2.0-2.6) g/100 mL] compared with mothers of non-operated neonates [2.9 (2.2-3.1) g/100 mL] and controls [2.7 (2.3-3.3) g/100 mL] (P = 0.045). Operated neonates exhibited a greater decrease in WAZ from birth to discharge than non-operated neonates (P = 0.008). Postoperative WAZ decline was associated with the postoperative period severity and delayed reintroduction of BM feeding. Higher calorie and fat intake on postoperative day 14 was significantly associated with a smaller WAZ decrease (P < 0.05). Later postoperative achievement of full enteral feeding independently predicted WAZ decline. In the operated group the colostrum protein content positively correlated with weight gain during the early neonatal period.
CONCLUSION: Colostrum from mothers of operated neonates with CHD had reduced fat content. BM composition did not affect WAZ trajectories. However, delayed achievement of full enteral feeding independently predicted WAZ decline.