P3.B022: Growth in premature infants- A comparison of infants fed maternal breast milk and donor breast milk

Background: Optimal nutrition is one of the leading contributors in reducing overall morbidity and mortality of premature infants. Researchers have determined that breast milk is the ideal form of enteral nutrition compared to bovine-based formula milk and there have been numerous studies evaluating the best form of breast milk to give preterm infants. A common obstacle the physician faces caring for these preterm infants is lack of supply of mother’s own milk (EBM). This presented the opportunity for donor breastmilk (DBM) to be offered to babies in the NICU. EBM is thought to be more specific for the nutritional needs of the infant. There has been some debate regarding the nutritional characteristics of DBM as it typically comes from mothers who are not breastfeeding preterm infants. Additionally, term infants have different growth requirements compared to preterm infants. Literature review shows a paucity of information regarding the nutrient content of DBM. The study's main goal is to evaluate growth of infants mainly fed with EBM compared to DBM. This becomes an important question as more preterm infants are being delivered globally and being able to identify variation in growth velocity would allow for improved individualized nutrition. The ability to identify the specific nutritional requirements for optimal growth is one that continues to be investigated in the NICU.

Methods: This is a retrospective review to describe the relationship between infant growth utilizing Z scores and human milk source. A review of all patients meeting inclusion/exclusion criteria during the study period (10/13-10/23) will be performed. Patients' data obtained will be from standard of care treatment. Segmented regression analysis will be performed of the independent variables on the dependent variable to determine a correlation of early predictors. Project received IRB approval in 10/23.

Results: 377 patients met the data requested but only 196 met the inclusion criteria. EBM group had 115 patients and DBM group had 81 patients. Each group had a similar number of patients in different gestation ages: < 27wk (EBM 41%, DBM 43%), 27-30 wk (EBM 39%, DBM 44%) and >30wk (EBM 20% and DBM 12%)​. At 34 weeks, more infants were adequately nourished on EBM compared to DBM but this variation normalizes at the time of discharge. ​Patients fed predominately DBM during admission were more likely to be started on sodium supplementation during admission​. Over 50% of patients in both EBM and DBM group had some aspect of malnutrition (mild, moderate and severe) at 34 weeks gestation but at the time of discharge this improved to less than 50%.

Conclusion: Infants fed EBM had improved growth measured by change in Z scores compared to those fed DBM until 34 weeks of age. ​After 34 weeks of age, there is no significant difference noted​.