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- W2906132078 abstract "Necrotizing enterocolitis (NEC) is a multifactorial disease of the intestinal tract associated with significant morbidity and mortality in neonates. The highest risk for developing NEC are neonates <1,000 grams, <28 weeks, or with congenital heart defects. The American Academy of Pediatrics recommends human milk (HM), including donor milk (DM), for preterm infants. As such, exclusive HM diets in extremely low birth weight (ELBW) infants have increased with the implementation of donor milk feeding protocols as a supplement to mother’s own milk (MOM) throughout the US. To date, no study has evaluated the risk of NEC in ELBW infants on bovine milk-based diets compared to exclusive human milk-based diets (HMBD). This was a single site retrospective (2006-2012) cohort study of ELBW infants (birth weight <1000 g). Exclusion criteria included major congenital anomalies, death within 12 hours of admission, or outborns admitted after 1 week of age. Of the 576 infants meeting inclusion criteria, 238 (41.3%) received a bovine milk-based diet (BOV, a diet including formula and/or bovine milk-based fortification), and 338 infants (58.7%) received exclusive HMBD (no bovine products). Statistical methodology included Student’s t-test, Fisher’s exact test, and multivariate logistic regression. ELBW infants in the HMBD cohort had significantly lower odds of NEC (OR =0.39, 95% CI: 0.22-0.68, p<0.001), but not in mortality rates (OR = 0.75, 95% CI: 0.50-1.12, p=0.181). Characteristics between the two cohorts are seen in Table 1 . The mean length of stay was not different between the groups (92.3 ± 58.6 vs 94.5 ± 71.4 days, p=0.674). After controlling for use of antenatal corticosteroids, indomethacin or ibuprofen for treatment of a PDA, and diagnosis with PDA or culture-positive sepsis, neonates in the HMBD cohort continued to have significantly lower odds of NEC (adjusted OR = 0.42, 95% CI: 0.23-0.76, p=0.005) (Figure 1). We have demonstrated for the first time that among neonates at greatest risk for NEC (ELBW), we observed a significant reduction in NEC rates with the introduction of exclusive HMBD including expressed MOM, donor breast milk, and donor breast milk fortification products. These findings are the first to demonstrate that there is a nearly 60% reduction in the odds of NEC among <1000 gram neonates by limiting feeds to only human milk-based.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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- W2906132078 date "2019-01-01" @default.
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- W2906132078 title "937: Decreased rates of necrotizing enterocolitis associated with exclusive human milk-based diet" @default.
- W2906132078 doi "https://doi.org/10.1016/j.ajog.2018.11.961" @default.
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