Donor milk intake and infant growth in a South African neonatal unit: a cohort study

dc.contributor.authorSparks, Hayley
dc.contributor.authorLinley, Lucy
dc.contributor.authorBeaumont, Jennifer L
dc.contributor.authorRobinson, Daniel T
dc.date.accessioned2018-09-10T07:22:33Z
dc.date.available2018-09-10T07:22:33Z
dc.date.issued2018-09-04
dc.date.updated2018-09-09T03:20:44Z
dc.description.abstractBackground Implications of donor milk feedings on infant growth in resource limited settings remain uncertain. This knowledge gap includes the impact of donor milk availability on infant intake of mother’s own milk. Therefore, this investigation aimed to measure intake and growth in infants receiving donor milk when born to women from resource limited backgrounds with high rates of human immunodeficiency virus (HIV). Methods A retrospective cohort study enrolled eligible infants admitted to a South African combined neonatal intensive and secondary high care unit, within a one year admission period during 2015, with signed consent for donor milk feedings. A certified milk bank provided donor milk. Daily nutritional intake during the first month was recorded. Details included proportional intake of donor milk, mother’s own milk and infant formula. The primary outcome of infant growth velocity from day back to birth weight to discharge was calculated when length of stay was ≥14 days. Analyses primarily used T-tests; mixed effects models compared weekly calorie intake. Results One hundred five infants with donor milk consent were born at 30.9 ± 3.6 weeks of gestation, weighing 1389 ± 708 g. Forty percent of mothers had HIV. Infant growth velocity did not differ based on percent of feedings as donor milk (≥ 50%: 11.8 ± 4.9 g/kg/d; < 50%: 13.5 ± 5.3 g/kg/d; p = 0.3). Percent of feedings from donor milk was similar based on maternal HIV status (positive: 31 ± 25%; negative: 36 ± 29%; p = 0.4), as was percent of feedings as mother’s milk (positive: 53 ± 35%; negative: 58 ± 30%; p = 0.4). Calorie intake increased markedly during the first two weeks and then plateaued (p < 0.0001). Conclusions Donor milk feedings in higher proportions did not further impair growth of infants managed in a South African combined neonatal intensive and secondary high care unit with growth rates already below reference ranges. The provision of donor milk contributed to feedings being composed of primarily human milk during the first month. Increasing early calorie intake may improve infant growth in this center.
dc.identifier.apacitationSparks, H., Linley, L., Beaumont, J. L., & Robinson, D. T. (2018). Donor milk intake and infant growth in a South African neonatal unit: a cohort study. <i>International Breastfeeding Journal</i>, http://hdl.handle.net/11427/28446en_ZA
dc.identifier.chicagocitationSparks, Hayley, Lucy Linley, Jennifer L Beaumont, and Daniel T Robinson "Donor milk intake and infant growth in a South African neonatal unit: a cohort study." <i>International Breastfeeding Journal</i> (2018) http://hdl.handle.net/11427/28446en_ZA
dc.identifier.citationSparks, H., Linley, L., Beaumont, J. L., & Robinson, D. T. (2018). Donor milk intake and infant growth in a South African neonatal unit: a cohort study. International Breastfeeding Journal, 13(1), 41.
dc.identifier.ris TY - Journal Article AU - Sparks, Hayley AU - Linley, Lucy AU - Beaumont, Jennifer L AU - Robinson, Daniel T AB - Background Implications of donor milk feedings on infant growth in resource limited settings remain uncertain. This knowledge gap includes the impact of donor milk availability on infant intake of mother’s own milk. Therefore, this investigation aimed to measure intake and growth in infants receiving donor milk when born to women from resource limited backgrounds with high rates of human immunodeficiency virus (HIV). Methods A retrospective cohort study enrolled eligible infants admitted to a South African combined neonatal intensive and secondary high care unit, within a one year admission period during 2015, with signed consent for donor milk feedings. A certified milk bank provided donor milk. Daily nutritional intake during the first month was recorded. Details included proportional intake of donor milk, mother’s own milk and infant formula. The primary outcome of infant growth velocity from day back to birth weight to discharge was calculated when length of stay was ≥14 days. Analyses primarily used T-tests; mixed effects models compared weekly calorie intake. Results One hundred five infants with donor milk consent were born at 30.9 ± 3.6 weeks of gestation, weighing 1389 ± 708 g. Forty percent of mothers had HIV. Infant growth velocity did not differ based on percent of feedings as donor milk (≥ 50%: 11.8 ± 4.9 g/kg/d; < 50%: 13.5 ± 5.3 g/kg/d; p = 0.3). Percent of feedings from donor milk was similar based on maternal HIV status (positive: 31 ± 25%; negative: 36 ± 29%; p = 0.4), as was percent of feedings as mother’s milk (positive: 53 ± 35%; negative: 58 ± 30%; p = 0.4). Calorie intake increased markedly during the first two weeks and then plateaued (p < 0.0001). Conclusions Donor milk feedings in higher proportions did not further impair growth of infants managed in a South African combined neonatal intensive and secondary high care unit with growth rates already below reference ranges. The provision of donor milk contributed to feedings being composed of primarily human milk during the first month. Increasing early calorie intake may improve infant growth in this center. DA - 2018-09-04 DB - OpenUCT DP - University of Cape Town J1 - International Breastfeeding Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Donor milk intake and infant growth in a South African neonatal unit: a cohort study TI - Donor milk intake and infant growth in a South African neonatal unit: a cohort study UR - http://hdl.handle.net/11427/28446 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13006-018-0183-8
dc.identifier.urihttp://hdl.handle.net/11427/28446
dc.identifier.vancouvercitationSparks H, Linley L, Beaumont JL, Robinson DT. Donor milk intake and infant growth in a South African neonatal unit: a cohort study. International Breastfeeding Journal. 2018; http://hdl.handle.net/11427/28446.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDivision of Neonatologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.sourceInternational Breastfeeding Journal
dc.source.urihttps://internationalbreastfeedingjournal.biomedcentral.com/
dc.subject.otherMilk bank
dc.subject.otherHuman milk
dc.subject.otherDonor milk
dc.subject.otherInfant growth
dc.subject.otherVery low birth weight
dc.subject.otherPremature infant
dc.titleDonor milk intake and infant growth in a South African neonatal unit: a cohort study
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
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