Complications and growth of very low birth weight infants fed by breast feeding versus formula feeding / 中华围产医学杂志

ABSTRACT

Objective To study the incidence of complications and the influence on early postnatal growth and development in very low birth weight infant(VLBWI) fed by breast milk.Methods From January 1, 2010 to December 31, 2013, 351 VLBWIs, who were appropriate for gestational age and hospitalized in Neonatal Intensive Care Unit of Tianjin Central Hospital of Obstetrics and Gynecology, were included in this study after exclusion of those with small for gestational age, large for gestational age, severe perinatal asphyxia at birth, withdrawing treatment or death, and mixed feeding infants.The group of formula-fed infants (FFI) were 168 VLBWI admitted between January 1, 2010 to December 31, 2011 and the group of breast milk-fed infants (BFI) were 183 VLBWI admitted between January 1, 2012 to December 31, 2013.For BFIs, we added human milk fortifier when oral intake reached 100 ml/kg.All subjects were followed up to 40 weeks of corrected gestational age.We compared the incidence of complications and infantile growth and development from birth to 30 days old between the two groups.Independent sample t-test and Chi-square test were applied for statistical analysis.Results The incidence of feeding intolerance in FFIs was higher than that of the BFIs [27.4％ (46/168) vs 15.3％ (28/183)], so was the incidence of necrotizing enterocolitis [14.9％ (25/168) vs 5.5％ (10/183)] (x2=7.683 and 8.651, both P ＜ 0.05).The incidence of nosocomial infection, retinopathy of prematurity and bronchopulmonary dysplasia in FFI and BFI were 34.5％ (58/168) vs 33.3％ (61/183), 15.5％ (26/168) vs 10.4％ (19/183), and 11.3％ (19/168) vs 9.3％ (17/183), but none of them showed significant difference between the two groups (x2=0.055, 2.033 and 0.388, all P ＞ 0.05).Significant difference was neither found in weight gain from birth to 30 days old [(304± 137) vs (308± 123) g], height growth [(2.6± 1.1) vs (2.7± 1.2) cm] and head circumference growth [(2.5± 1.0) vs (2.4±0.9) cm] between the FFIs and BFIs (t=0.106, 0.614 and 0.485, all P ＞ 0.05).Conclusion Breast feeding is beneficial to VLBWI in decreasing the incidence of feeding intolerance and necrotizing enterocolitis without adverse effect on their early postnatal growth and development.