Assessing multiple factors affecting the gut microbiome structure of very preterm infants

The composition and diversity of the gut microbiota are essential for the health and development of the immune system of infants. However, there is limited information on factors that influence the gut microbiota of very preterm infants. In this study, we analyzed factors that affect the gut microbiota of very preterm infants. The stool samples from 64 very preterm infants with a gestational age less than 32 weeks were collected for 16S rRNA gene sequencing. The infants were divided according to the delivery mode, antibiotic use during pregnancy, and feeding methods. The abundance of Proteobacteria was high in both cesarean (92.7%) and spontaneous (55.5%) delivery groups and then shifted to Firmicutes after the first week of birth. In addition, Proteobacteria was also the dominant phylum of infant gut microbiome for mothers with antibiotic use, with more than 50% after the first week of birth. In comparison, the dominant phylum for mothers without antibiotic use was Firmicutes. Proteobacteria level was also high in breastfeeding and mixed-feeding groups, consisting of more than 90% of the community. By contrast, Proteobacteria was the dominant phylum at the first week of birth but then shifted to Firmicutes for the formula-fed group. The alterations of gut microbiota in infants can affect their health condition during growth. This study confirmed that the different feeding types, delivery modes, and use of antibiotics during pregnancy can significantly affect the composition of the gut microbiota of very preterm infants.

Effects of intermittent feeding and continuous feeding on muscle atrophy and nutritional status in critically ill patients / 中华危重病急救医学

Objective:To compare the effects of intermittent feeding and continuous feeding on muscle atrophy, nutritional status and nutritional intolerance of critically ill patients, and to provide a reference for critically ill patients to select more suitable nutritional support in clinic.Methods:An observational study was conducted. The clinical data of 59 critically ill patients who received enteral nutrition admitted to anesthesia intensive care unit (ICU) of the Second Affiliated Hospital of Air Force Military Medical University of the Chinese People's Liberation Army from January 2019 to December 2020 were analyzed. According to different feeding methods, the patients were divided into intermittent feeding group ( n = 32, 200-250 mL nutrient solution was pumped each time, 4-5 times a day, 5-6 hours interval each time) and continuous feeding group ( n = 27, nutrient solution was pumped continuously and evenly). The changes of related indexes before and 7 days after enteral nutrition in ICU were recorded, including rectus femoris thickness and cross-sectional area, nutritional status related indexes [hemoglobin (Hb), albumin (ALB), prealbumin (PA) and blood glucose], incidence of aspiration, diarrhea, constipation, vomiting, abnormal gastric residue volume (gastric residue volume > 250 mL), other nutritional intolerance and the length of ICU stay. Results:After nutritional support for 7 days, the thickness and cross-sectional area of rectus femoris decreased in both groups, indicating muscle atrophy occurred in both groups, and there was no significant difference in change value of thickness or cross-sectional area of rectus femoris between intermittent feeding group and continuous feeding group [the change value of rectus femoris thickness (cm): -0.06±0.04 vs. -0.07±0.03, the change value of rectus femoris cross-sectional area (cm 2): -0.71±0.23 vs. -0.81±0.24, both P > 0.05]. There were no significant differences in nutritional status related indicators after nutritional support for 7 days between intermittent feeding group and continuous feeding group [Hb (g/L): 102.2±10.9 vs. 103.2±11.3, ALB (g/L): 34.1±3.6 vs. 32.9±4.0, PA (mg/L): 209.8±10.6 vs. 205.9±13.7, blood glucose (mmol/L): 6.34±1.91 vs. 6.93±3.54, all P > 0.05]. The patients in both groups had intestinal nutrition intolerance such as aspiration, diarrhea, constipation and vomiting. However, the incidence of abnormal gastric residual volume in intermittent feeding group was significantly lower than that in continuous feeding group [9.4% (3/32) vs. 33.3% (9/27), P < 0.05]. There was no significant difference in the length of ICU stay between intermittent feeding group and continuous feeding group (days: 21.03±11.51 vs. 21.41±9.74, P > 0.05). Conclusions:Compared with continuous feeding, intermittent feeding does not improve the muscle atrophy and nutritional status of critically ill patients, but reduce the symptoms of enteral nutrition intolerance caused by abnormal increase of gastric residual volume. It is an easy-to-implement, safe and feasible feeding method.

Factors Associated with the Method of Feeding Preterm Infants after Hospital Discharge

PURPOSE: To investigate factors that may affect the method of feeding among preterm infants at 4 weeks after discharge. METHODS: This study included 222 mother-infant dyads born before a gestational age of 37 weeks. The feeding method and general medical characteristics of the participants were assessed at 4 weeks after discharge using a structured questionnaire. Multinomial logistic regression analysis was used to examine which factors were associated with breastfeeding at home. RESULTS: Of the 222 infants who qualified for the study, 71 (32.9%) continued to receive breastmilk at 4 weeks post-discharge. Multinomial logistic regression analysis showed that breastfeeding at 4 weeks post-discharge was associated with higher breastfeeding self-efficacy, vaginal delivery (experience), direct breastfeeding in the neonatal intensive care unit (NICU), gestational age between 30 and 34 weeks, and breastmilk consumption in the NICU. The following factors were associated with mixed feeding at 4 weeks post-discharge: being employed, having higher breastfeeding self-efficacy, and direct breastfeeding in the NICU. CONCLUSION: NICU nurses should provide opportunities for direct breastfeeding during hospitalization and support breastfeeding to enhance breastfeeding self-efficacy. These factors may help to ensure the continuation of breastfeeding after discharge. Moreover, factors that affect breastfeeding should be considered when providing interventions.

Influences of different feeding methods on feeding tolerance and nutritional status of preterm infants / 现代临床护理

Objective To explore the influence of different feeding methods on feeding tolerance and nutritional status of preterm infants.Methods Forty-eight cases of preterm infants were randomly divided into experiment group and control group,24 cases in each group.The experiment group adopt 24 hours continuous feeding by infusion pump,and the control group with syringe injection,with injection time of 3~5mins every 2 hours.The two groups were compared in terms of feeding tolerance,body weight and nutritional status.Results The feeding intolerance of experiment group was lower than that in the control group,weight and prealbumin were higher than those in the control group(P<0.05 or P<0.01).Conclusion The continuous feeding is the ideal feeding method,which can improve growth,feeding tolerance and nutritional status of preterm infants.

A Survey on General Characteristics and Feeding Methods of the Premature Infants

The purpose of this study is to provide basic data for the medical nutrition therapy of premature infants. The general characteristics, presence of metabolic disorders, hematological profile and feeding methods were compared between the premature infant group (<37 weeks, n=61) and the full-term infant group (37~42 weeks, n=165). Birth weight (p<0.0001), birth length (p<0.005), head circumference (p<0.0001), chest circumference (p<0.0001), and Apgar scores (p<0.0001) of the neonates were all statistically lower in the premature infant group. Jaundice cases (p<0.0001) were statistically higher in the premature infant group. White blood cell counts (WBC: p<0.005), mean corpuscular volume (MCV: p<0001), mean corpuscular hemoglobin (MCH: p<0.005), mean corpuscular hemoglobin concentration (MCHC: p<0.005), and mean platelet volume (MPV: p<0.05) were statistically lower in the premature infant group. The premature infant group were fed a higher rate of premature formula than breast milk and the full-term infant group were fed a high rate of human milk at a higher rate, showing differences in kinds of feeding methods (p<0.0001) between the two groups. An infant's birth weight showed a significantly positive correlation with the infant's birth length (p<0.0001), head circumference (p<0.0001), chest circumference (p<0.0001), and Apgar scores(p<0.0001). The birth length also showed a significantly positive correlation with both head circumference (p<0.05) and chest circumference (p<0.05). Head circumference showed a significantly positive correlation with chest circumference (p<0.0001) and Apgar scores (p<0.0001). Chest circumference showed a significantly positive correlation with Apgar scores (p<0.0001). In addition, the Apgar Score at of 1 minute after birth showed a significantly positive correlation with the Apgar score at of 5 minute after birth (p<0.0001).

Milk Feeding Methods and the Changes of Serum Lactate Level in Infants with Iron Deficiency Anemia

PURPOSE: Infants undergo critical and rapid stages of growth. Optimal nutrition during this period is therefore essential. Iron deficiency is especially impotant and common. The aim of this study was to determine the present status and problems of milk feeding methods in infants with iron deficiency anemia and, futhermore, to develop appropriate feeding guidelines for adequate iron nutrition. Latate is the end product of the anaerobic metabolism of glucose. Also we studied the changes of serum lactate level in this patients and calculated correlations between serum lactate level and diagnostic parameters of iron deficiency anemia. METHODS: We studied 42 children with iron deficiency anemia who visited Wonkwang university hospital from February 1995 to July 1996. We analyzed the type and duration of milk feeding method. And we measured serum lacate level and diagnostic parameters of iron deficiency anemia. RESULTS: The mean age was 17.0 months and male to female ratio was 7:1. On the analysis of milk feeding methods the breast feeding, the cow's milk, the mixed feeding were 73.8%, 11.9%, 14.3% respectively. The breast feeding group distributed mainly from 6 month to 18 month and 1 patient showed prolonged breast feeding until 48 month. We checked serum lactate level in 22 subjects. The mean serum lactate level was increased than normal adult level but there were no significant correlation between serum lactate level and diagnostic parameters of iron deficiency anemia (Hb, Hct, MCV, MCH, MCHC, serum iron, TIBC, ferritin). CONCLUSION: The most common problem of milk feeding method in infants with iron deficiency anemia was prolonged breast feeding and some infants fed excessive cow's milk. We need correct and proper education about merits and disadvantages of breast and cow's milk feeding to mothers. The mean serum lactate level in children with iron deficiency anemia was increased but serum lacate level can't use a diagnostic parameter of iron deficiency anemia.

Cross-sectional Study of Growth of Korean Breast Fed Formula Fed Infants from 1 to 3 Postpartum Months / 대한지역사회영양학회지

One-to three -month-old infants(n=252) were compared their growth performance(weight, length, head circumference, chest circumference) by feeding methods in cross-sectional study. There were two groups : breast-fed(BF) and formula-fed groups(FF). The weights of infants at 1, 2, and 3 postpartum month were 4.50+/-.48kg, 5.76+/-0.62kg and 6.67+/-0.68kg, respectively. The weigh of male infants was higher than females. The length were 53.7+/-2.6cm, 57.4+/-3.3cm, 61.1+/-3.1cm at one to three postpartum months, respectively. The length of male infants was higher than females, too. Overall there were no significant differences between feeding methods in weight, length, head and chest circumferences, and monthly weight and length velocity. But 3-month-old formula-fed male infants showed bigger significantly in weight, monthly weight velocity and chest circumference than the breast-feds. By Korean standards, weight-for-height Z-score were distributed from 0 to +2. Not only was there a few malnourished infants but also overnourished were noticed, especially in formula-fed group.