Impact of Exclusively Administered Hindmilk-Rich Feeds on Weight Gain in Preterm Neonates
Keywords:
Anthropometry, Neonatal nutrition, Breast milk feeding, Neonatal growth, Low birth weight, Preterm neonates, HindmilkAbstract
Introduction:Preterm and low-birth-weight (LBW) neonates are at heightened risk of growth failure and neonatal morbidity due to immature gastrointestinal systems and high metabolic demands. Human breast milk, particularly hindmilk, is rich in fat and calories and may enhance early postnatal growth. This study aimed to evaluate the impact of hindmilk feeding on the growth parameters of preterm neonates compared to standard composite milk feeding.
Materials and Methods:A prospective observational study was conducted over 12 months (January–December 2024) in the Department of Pediatrics at a tertiary care hospital in Kanchipuram. A total of 100 preterm neonates (<37 weeks gestation, <2500 grams) without clinical complications were enrolled and randomly assigned to two groups. Group 1 (n = 50) received exclusively expressed hindmilk; Group 2 (n = 50) received composite milk feeds. Daily weight and weekly head circumference and length were measured for two weeks or until discharge. Data were analyzed using SPSS Version 20.0, with p < 0.05 considered statistically significant.
Results:At baseline, both groups were comparable in admission weight and APGAR scores. However, Group 1 neonates had slightly lower gestational age, head circumference, and length. By discharge, the hindmilk group showed significantly greater improvements in weight (p = 0.02), head circumference (p = 0.04), and length (p = 0.001) compared to the composite milk group. Subgroup analysis also revealed enhanced growth in neonates between 28–32 weeks gestation in the hindmilk group.
Conclusion:Hindmilk feeding significantly improved early growth outcomes in preterm and LBW neonates, supporting its role as a practical and safe nutritional strategy. Promoting maternal education and implementing hindmilk-focused feeding protocols in NICUs may contribute to better neonatal health and development
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Cooke RJ, Ainsworth SB, Fenton AC: Postnatal growth retardation: a universal problem in preterm infants . Arch Dis Child Fetal Neonatal Ed. 2004, 89:428-30. 10.1136/adc.2001.004044
American Academy of Pediatrics: Pediatric nutrition. Kleinman RE, Greer FR (ed): American Academy of Pediatrics, Elk Grove Village, IL; 2014. https://www.vasiliadis-books.gr/Vasiliadis-books/wp content/uploads/2015/06/PEDIATRIC-NUTRITION-LOOK-INSIDE.pdf.
Anatolitou F: Human milk benefits and breastfeeding. J Pediatr Neonat Individual Med. 2012, 23:11-8. 10.7363/010113
Mosca F, Giannì ML: Human milk: composition and health benefits. Pediatr Med Chir. 2017, 39:155. 10.4081/pmc.2017.155
Ogechi AA, William O, Fidelia BT: Hindmilk and weight gain in preterm very low-birthweight infants. Pediatr Int. 2007, 49:156-60. 10.1111/j.1442-200X.2007.02336.
x Spencer SA, Hendrickse W, Roberton D, Hull D: Energy intake and weight gain of very low birthweight babies fed raw expressed breast milk. Br Med J (Clin Res Ed). 1982, 285:924-6. 10.1136/bmj.285.6346.924
Valentine CJ, Hurst NM, Schanler RJ: Hindmilk improves weight gain in low-birth-weight infants fed human milk. J Pediatr Gastroenterol Nutr. 1994, 18:474-7. 10.1097/00005176-199405000-00013 Slusher T, Hampton R, Bode-Thomas F, Pam S,
Akor F, Meier P: Promoting the exclusive feeding of own mother's milk through the use of hindmilk and increased maternal milk volume for hospitalized, low birth weight infants (< 1800 grams) in Nigeria: a feasibility study. J Hum Lact. 2003, 19:191-8. 10.1177/0890334403252490
Alshaikh BN, Festival J, Reyes Loredo A, Yusuf K, Towage Z, Fenton TR, Wood C: Hindmilk as a rescue therapy in very preterm infants with suboptimal growth velocity. Nutrients. 2023, 15:929. 10.3390/nu15040929
Hård AL, Nilsson AK, Lund AM, Hansen-Pupp I, Smith LE, Hellström A: Review shows that donor milk does not promote the growth and development of preterm infants as well as maternal milk. Acta Paediatr. 2019, 108:998-1007. 10.1111/apa.14702
Prentice P, Ong KK, Schoemaker MH, et al.: Breast milk nutrient content and infancy growth . Acta Paediatr. 2016, 105:641-7. 10.1111/apa.13362
Shukla VV, Bann CM, Ramani M, et al.: Predictive Ability of 10-Minute Apgar Scores for Mortality and Neurodevelopmental Disability. Pediatrics. 2022, 149:149. 10.1542/peds.2021-054992
Costa TL, Mota A, Duarte S, Araujo M, Ramos P, Machado HS, Lemos P: Predictive factors of Apgar scores below 7 in newborns: can we change the route of current events?. J Anesth Clin Res. 2016, 7:10. 10.4172/2155-6148.1000672
Berger HM, Scott PH, Kenward C, Scott P, Wharton BA: Milk pH, acid base status, and growth in babies . Arch Dis Child. 1978, 53:926-30. 10.1136/adc.53.12.926
Altun-Köroğlu O, Ozek E, Bilgen H, Cebeci D: Hindmilk for procedural pain in term neonates . Turk J Pediatr. 2010, 52:623-9.
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