OPTIMIZATION OF ENTERAL FEEDING IN EXTREMELY PREMATURE NEONATAL INFANTS IN THE HOSPITAL SETTING

Objective. To give a comparative analysis of the efficiency of using native breast milk as the only nutritional substrate, multinutrient fortifier Friso-reinforced breast milk, and a specialized formula in the feeding of premature babies. Subjects and methods. Fifty-two premature neonates born at 26-to-32 weeks gestation and weighing less than 1500 g were examined. The exclusion criteria were severe congenital malformations, brain structural damages, sepsis, acute renal failure, and hemolytic disease of the newborn needing blood substitute transfusion. According to the type of a major enteral substrate, the premature neonates were divided into three groups: 1) 11 babies receiving native breast milk (NBM); 2) 23 babies taking native breast milk reinforced with the multinutrient fortifier Friso (Friesland, Foods, the Netherlands) (RNBM); 3) 18 infants having a specialized cow’s milk-based formula (SF) for the premature newborn. The results of clinical and laboratory studies were assessed from birth to 38th weeks of postconceptual age or to the baby’s hospital discharge if the latter occurred earlier. Results. The daily weight gain averaged 16.13 g/kg/day in the RNBM group versus 14.2 and 13.8 g/kg/day in the NBM and SF groups, respectively. At the 37th week of postconceptual age, the fat mass increase was maximally approximated to the fetal one in the RNBM group as compared to the SF and NBM groups (348 g versus 220 and 256 g, respectively). Conclusion. Comparison of the rate of weight and fat mass gains leads to the conclusion that breast milk reinforced with the multinutrient fortifier Friso is the best choice for feeding extremely and very low birth weight babies.

premature infants, extremely and very low birth weight, feeding, multinutrient fortifier Friso-reinforced breast milk