Neonatal GI Physiology & NEC 4: Gut Health, Enteral Nutrition and Oral Feeding
82 - Comparison Of Growth Velocity In Preterm Infants Using Continuous Versus Standard Human Milk Warming Method: A Retrospective Analysis
Saturday, April 29, 2023
3:30 PM – 6:00 PM ET
Poster Number: 82 Publication Number: 82.236
Samantha Brunk, Oklahoma Childrens Hospital at OU Health, Choctaw, OK, United States; Susan M. Bedwell, Oklahoma Childrens Hospital at OU Health, Guthrie, OK, United States; Lise DeShea, University of Oklahoma College of Medicine, Oklahoma City, OK, United States; Szyld Edgardo, University of Oklahoma College of Medicine, oklahoma city, OK, United States; William H. Beasley, University of Oklahoma HSC, Norman, OK, United States; krishnamurthy Sekar, University of Oklahoma, Oklahoma City, OK, United States; Erynn M. Bergner, University of Oklahoma College of Medicine, Oklahoma City, OK, United States
Resident Oklahoma Childrens Hospital at OU Health Choctaw, Oklahoma, United States
Background: Both provision of human milk (HM) and improved growth velocity are associated with better outcomes in preterm infants. However, nutrient loss incurred in the delivery of HM to preterm infants remains a challenge and a significant gap exists in means to optimize enteral feeding systems for this population. A prior pilot study found continuous milk warming devices had improved weight gain outcomes compared to standard milk warming practices in a short (10-day) intervention period. Objective: To further evaluate the impact of the use of a continuous milk warming system on growth velocity in preterm infants over a longer period of time in routine NICU practice. Design/Methods: In a retrospective chart review, we evaluated very low birth weight (BW) infants fed an exclusive HM diet via nasogastric or orogastric feeding and compared weight gain velocity based on milk warming process (standard vs continuous). Baseline data included demographics, anthropometrics, markers of initial illness severity, percentage of mother’s milk received, and comorbidities of prematurity. Weekly growth measurements were recorded from the time infants reached full enteral feeds (140cc/kg/day) to when they either transitioned to a new diet or started oral feeds and used to calculate growth velocities. Only infants who were observed for at least 10 days were included. Secondary outcomes included length and head circumference velocities and feeding tolerance outcomes. Chi square tests were used for categorical variables, and Welch’s t tests for unequal n’s were used for quantitative variables. Results: We evaluated 168 infants (mean BW=1051g, SD=236; mean gestational age=28 weeks, SD=1.6) who received either standard (n=85) or continuous (n=83) milk warming for feeds. The groups were statistically similar on baseline characteristics. The groups did not differ on weight velocity (standard 16.3g/kg/d vs continuous 16.2g/kg/d, CI [-1.02, 1.18], p=0.89) or length velocity (0.95 vs 1.04cm/week, CI [-0.27, 0.10], p=0.36). The continuous warming group had significantly faster head circumference growth (0.9 vs 0.8cm/week, CI [-0.25, -0.05], p=0.003) (Figure 1). Feeding tolerance did not differ (p=0.88).
Conclusion(s): Preterm infants fed an exclusive HM diet via continuous milk warming device had faster head circumference and similar weight and length velocities in comparison to standard warming when utilized as part of routine clinical practice. Further prospective studies are needed to investigate the role of continuous milk warming in enteral feeding systems and its effect on growth in preterm infants.
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