Association of the addition of a multicomponent additive to the human milk provided to preterm newborns with outcomes: A prospective cohort

Abstract

Background

The nutritional needs of preterm newborns (PTNB) are increased and enhancing nutritional management is essential to meet them. The addition of multicomponent additive (MA) to human milk (HM) is used as a treatment strategy. The objective of the research is to analyze the association between the use of MA added to HM with nutritional and clinical outcomes in low-birth weight PTNB admitted to a neonatal intensive care unit (NICU).

Methods

Prospective cohort study with PTNB weighing less than 2500 g during hospitalization in the NICU, who were divided into two distinct groups based on the presence or absence of MA supplementation. We investigated outcomes related to nutritional status at discharge, length of stay, presence of metabolic bone disease of prematurity (MBDP), extrauterine growth restriction (EUGR) and encouragement of breastfeeding at discharge.

Results

A total of 65 PTNB were included. We found that the lower the BW, the more often the use of MA was observed (p = 0.006). At discharge, there was a decline in z- scores, in which 46 % of PTNB who used MA developed malnutrition. The length of stay was longer in the group of PTNB who used MA (p < 0.001). The percentage of PTNB with MBDP who used MA (52.5 %) was higher than the percentage of those who did not use it (p = 0.006). The probability of PTNB with MBDP using MA is 2.65 times higher than those without MDBP.

Conclusion

The use of MA to HM did not prevent or avoid the decline in nutritional status of the PTNBs, considering that those who used it had greater difficulty gaining weight, longer hospital stays, and more MBPD diagnoses compared to the group that did not use supplementation. However, the MA was crucial as it provided essential nutritional support for those PTNB who are more susceptible to MBDP.