Elsevier

The Journal of Pediatrics

Volume 153, Issue 5, November 2008, Pages 616-621.e2
The Journal of Pediatrics

Original article
Growth and Bone Mineralization in Preterm Infants Fed Preterm Formula or Standard Term Formula after Discharge

https://doi.org/10.1016/j.jpeds.2008.05.042Get rights and content

Objective

To evaluate growth and bone mineralization in very low birth weight (VLBW) infants fed preterm formula (PF) or term formula (TF).

Study design

In a double-blind prospective study, 49 preterm infants of gestational age 33 weeks or less were randomly fed PF or TF for 2 months after discharge, then all of the infants were fed TF for the next 2 months. Anthropometric and dual-energy x-ray absorptiometry data were collected at discharge and at 2 months and 4 months after discharge. Anthropometric data also were collected at 12 months postterm.

Results

Four months after discharge, both body weight (6139 ± 1254 g vs 5540 ± 863 g; P = .03) and bone mineral content (104.4 ± 29.2 g vs 87.5 ± 17.1 g; P = .01) were significantly higher in the PF group compared with the TF group. At 12 months postterm, mean body weight, length, and head circumference remained higher in the PF group than in the TF group, and body mass index was similar and within the normal range in the 2 groups.

Conclusions

At 4 months after discharge, growth and mineralization were better in the VLBW infants who were fed PF during the first 2 months after discharge compared with those who were fed TF, suggesting that PF may be particularly valuable at this early stage of development.

Section snippets

Study Design and Protocol

For this multicenter (2 tertiary care neonatal units located in Lyon and Montpellier, France), double-blind, prospective, randomized study, we recruited preterm infants with birth weight < 1750 g, gestational age of 33 weeks or less, and no major congenital malformations. According to the usual feeding protocol, all infants received human milk (fortified in those with milk intake > 70 mL/kg/day). When an infant's body weight reached 1500 g, the human milk feeding was switched progressively

Results

A total of 49 infants born between October 2001 and May 2004 were randomized, 23 to the PF group and 26 to the TF group (Figure 1; available at www.jpeds.com). There were no statistically significant differences between the 2 feeding groups at birth and at inclusion (Table II). There were 8 males in the PF group and 13 males in the TF group (P = .28). Birth weight SDS was −0.55 (1.54) in the PF group and −0.62 (1.37) in the TF group (P = .62). In the PF group, 21.7% (n = 5) of the infants were

Discussion

We found that BMC and growth were significantly greater in the preterm infants fed PF than in those fed a standard TF. A beneficial effect has not been systematically reported with the use of a moderately enriched (postdischarge) formula3, 15 but has been observed in subjects fed a PDF with higher protein and energy content.9, 11 Our analysis was not performed on an intention-to-treat basis, because some patients were lost to follow-up. However, loss to follow-up did not bias the study, because

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    Supported by the French Ministry of Health's Program for Clinical Research in Hospitals and by Nestlé France. The authors have no potential conflicts of interest to declare.

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