Archives of Disease in Childhood - Fetal and Neonatal Edition最新文献

{"title":"We should do better in accounting for multiple births in neonatal randomised trials: a methodological systematic review.","authors":"Kristy P Robledo, Sol Libesman, Lisa Nicole Yelland","doi":"10.1136/archdischild-2024-327983","DOIUrl":"10.1136/archdischild-2024-327983","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a methodological systematic review of multicentre trials of premature infants to (1) determine if and how multiple births have been considered in the design, analysis and reporting of recent trials and (2) assess whether there has been an improvement since the last review was conducted 10 years ago.</p><p><strong>Design: </strong>A systematic search was conducted in PubMed on 28 June 2023 for articles published between June 2018 and June 2023. Articles were eligible for inclusion if they were a multicentre randomised trial of infants born preterm and reported the results of a primary outcome that was measured on an infant or could be attributed to an infant.</p><p><strong>Results: </strong>We reviewed 62/74 trials (80%), after determining it was unclear if multiple births were present in the other 20%. 87% of trials (54/62) did not account for multiple births in their sample size calculations and 48% (30/62) did not account for clustering due to multiple births in their analyses. Problems were not limited to lower-ranked journals. No trials reported the intraclass correlation coefficient for any outcomes, indicating the degree of clustering present.</p><p><strong>Conclusions: </strong>Persistent problems remain with the design and analysis of multicentre trials of premature infants due to ignoring the complexity that comes with the inclusion of multiple births, despite methods available to address this. Trialists should consider the impact of multiple births in their trial design and analysis. Readers of neonatal trials should be aware of these issues, particularly those who peer review papers.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary artery peak Doppler velocity as an estimator of systemic blood flow and predictor of intraventricular haemorrhage in preterm infants: a multicentre prognostic accuracy study.","authors":"Sandra Terroba-Seara, Ignacio Oulego-Erroz, Daniel Palanca-Arias, Zenaida Galve-Pradel, Sara Delgado-Nicolás, Alicia Pérez-Pérez, Jorge Rodríguez-Ozcoidi, Ana Lavilla-Oíz, María Carmen Bravo, Leticia La Banda-Montalvo, Paula Méndez-Abad, Pamela Zafra-Rodríguez, Lorena Rodeño Fernandez, Jon Montero-Gato, Carmen Bustamante-Hervás, Cristina Vega-Del-Val, Javier Rodríguez-Fanjul, Juan Mayordomo-Colunga, Iosune Alegría-Echauri","doi":"10.1136/archdischild-2024-327196","DOIUrl":"10.1136/archdischild-2024-327196","url":null,"abstract":"<p><strong>Objectives: </strong>(1) To assess how main pulmonary artery peak Doppler velocity (MPAVpeak) correlates with right ventricular output (RVO) and superior vena cava flow (SVCf), (2) to assess the reproducibility of MPAVpeak and (3) to test the prognostic accuracy of MPAVpeak to predict high-grade intraventricular haemorrhage (IVH) or death at seventh day of life.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Nine third-level neonatal units in Spain.</p><p><strong>Patients: </strong>Preterm infants <33 weeks of gestational age who had standardised measurements of MPAVpeak, RVO and SVCf at 6, 12 and 24 hours of life.</p><p><strong>Main outcome measures: </strong>High-grade IVH or death at seventh day of life.</p><p><strong>Results: </strong>One hundred and ninety preterm infants with a median (IQR) gestational age and birth weight of 29.7 weeks (27.1-31.8) and 1152 g (892-1491), respectively, were included. High-grade IVH or death at seventh day of life occurred in 24 (12.6%). MPAVpeak was strongly correlated with RVO (Spearman <i>rho</i> 0.826-0.843). MPAVpeak discriminated well for low RVO (<120 mL/kg/min) at 6 (AUROC, area under the receiver operating characteristic curve=0.90), 12 (AUROC 0.94) and 24 hours (AUROC 0.86). Observer reproducibility was better for MPAVpeak (inter-observer limits of agreement ±8.4%) compared with RVO (±18.8%) and SVCf (±32.2%). The prognostic accuracy of MPAVpeak to predict high-grade IVH or death was good (AUROC >0.75) and non-inferior to RVO and SVCf (DeLong's test p>0.05).</p><p><strong>Conclusions: </strong>MPAVpeak is an adequate marker of systemic blood flow with high reproducibility and acceptable prognostic accuracy in preterm infants below 33 weeks of gestational age during the first day of life.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142790962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary hypertension in preterm neonates with bronchopulmonary dysplasia: a meta-analysis.","authors":"Dwayne Mascarenhas, Marwa Al-Balushi, Aida Al-Sabahi, Dany E Weisz, Amish Jain, Bonny Jasani","doi":"10.1136/archdischild-2024-327547","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327547","url":null,"abstract":"<p><strong>Context: </strong>Knowledge gaps exist on the incidence and risk factors for developing pulmonary hypertension (PH) in preterm infants with bronchopulmonary dysplasia (BPD) and its impact on outcomes.</p><p><strong>Objective: </strong>To systematically review and meta-analyse the incidence, risk factors and short- and long-term outcomes of BPD-PH in preterm infants.</p><p><strong>Design: </strong>PubMed, Embase, Cochrane CENTRAL and CINAHL were searched for studies including infants<37 weeks gestational age (GA) or birth weight<2500 g with BPD-PH versus BPD-no PH from inception until 5 April 2023.</p><p><strong>Main outcome measures: </strong>Incidence, risk factors and short- and long-term outcomes.</p><p><strong>Results: </strong>44 observational studies evaluating 7677 preterm infants were included. The incidence of PH in mild, moderate and severe BPD was 5%, 18% and 41%, respectively. Small for GA (25 studies; N=5814; OR 1.8; 95% CI 1.3, 2.5), necrotising enterocolitis (22 studies; N=3387; OR 1.6; 95% CI 1.3, 2.2), early PH (four studies; N=820 OR 2.2; 95% CI 1.5, 3.3) and severe BPD (20 studies; N=2587; OR 5.4; 95% CI 3.2, 9.1) were significant risk factors for BPD-PH. Compared with BPD-no PH, the BPD-PH group had significantly higher mortality (22 studies; N=4882; OR 6.4; 95% CI 4.7, 8.6), longer duration of mechanical ventilation, oxygen supplementation, length of hospital stay, need for home oxygen and tracheostomy requirement. The BPD-PH infants also had a significantly higher risk of neurodevelopmental impairment in the motor domain.</p><p><strong>Conclusions: </strong>PH increases across the severity of BPD and is associated with higher odds of mortality and adverse short-term and neurodevelopmental outcomes.</p><p><strong>Prospero registration number: </strong>CRD42023413119.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of visual distraction on neonatal mask ventilation: a simulation-based eye-tracking study.","authors":"Katharina Bibl, Michael Wagner, Robyn Dvorsky, Moritz Haderer, Vito Giordano, Peter Groepel, Angelika Berger, Travis Whitfill, Bashar Kadhim, Marc A Auerbach, Isabel T Gross","doi":"10.1136/archdischild-2024-327483","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327483","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate whether distractions during simulated neonatal resuscitation impact mask leakage and visual gaze patterns during positive pressure ventilation (PPV) of a newborn manikin.</p><p><strong>Study design: </strong>In this observational, simulation-based study, medical students and paediatric residents managed a neonate requiring resuscitation alongside a standardised team and executed PPV on a leak-free manikin. The scenario incorporated distractions such as chest compressions, preparation and insertion of an umbilical vein catheter, administering fluids and interpreting venous blood gas. Ventilation parameters were monitored using a respiratory function monitor, and participants were equipped with eye-tracking glasses to assess visual gaze patterns. Additionally, they self-assessed their level of distractions and estimated performance. Measures included dwell time, mask leak, minute volume and respiratory rate to determine whether PPV parameters and distractors were associated during times of interest (TOI).</p><p><strong>Results: </strong>We included 30 participants and observed statistically significant differences in the delivery of PPV parameters between TOIs with distractions compared with TOIs without distractions, as reflected in mask leak (31.0 vs 15.9 %), minute volume (202.0 vs 253.0 mL/kg/min) and respiratory rate (29.0 vs 33.0/min). Results on alterations in gaze behaviour showed a significant gaze shift from the infant's chest and airway to instruments and other areas of interest when distractions were present. During the venous blood gas interpretation, participants rated their performance worse than during other TOIs. Participants generally overrated their ventilation quality.</p><p><strong>Conclusion: </strong>This study showed a significant impact of distractions on PPV parameters and visual attention during simulated neonatal resuscitation.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognising uncertainty: an integrated framework for palliative care in perinatal medicine.","authors":"Dominic Wilkinson, Sophie Bertaud, Alexandra Mancini, Edile Murdoch","doi":"10.1136/archdischild-2024-327662","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327662","url":null,"abstract":"<p><p>In perinatal medicine, the number of babies with life-limiting or life-threatening conditions is increasing and the benefits of providing palliative care with a holistic, interdisciplinary approach are well documented. It can be particularly challenging, however, to integrate palliative care into routine care where there exists uncertainty about a baby's diagnosis or potential outcome.This framework, developed collaboratively by the British Association of Perinatal Medicine (BAPM) and the Association of Paediatric Palliative Medicine (APPM), offers supportive guidance for all healthcare professionals working in perinatal medicine across antenatal and neonatal services. It explicitly acknowledges that palliative care is not just for babies who are dying or who will certainly die in early life; incorporating a palliative approach into antenatal and neonatal care for all babies with an uncertain outcome can be particularly valuable. The framework provides guidance on recognising babies who may benefit from palliative care and outlines the key elements of perinatal palliative care: holistic family support, empowering parents to be parents, parallel planning, symptom management and loss and bereavement care. It provides recommendations for the delivery of palliative care services, advocating for a unified approach that involves all members of the perinatal team, supported by specialist services as needed.This framework calls for a shift in the philosophy and practice of perinatal care to integrate palliative care into the everyday and to recognise and embrace the challenge of uncertain prognosis.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young adult reflections on life experiences following preterm birth: a cross-sectional descriptive study.","authors":"Cheryl Anne Mackay, Caitlin Gray, Catherine Campbell, Mary Sharp","doi":"10.1136/archdischild-2024-327862","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327862","url":null,"abstract":"<p><strong>Background: </strong>Increasingly, preterm-born children are entering adulthood as survival at earlier gestational ages improves. However, there is little understanding of the lived experience in preterm-born adults.</p><p><strong>Methods: </strong>A cross-sectional descriptive study was conducted including young adults from a regional birth cohort of infants born <33 weeks in Western Australia. Participants provided written reflections of their experiences growing up and included messages for future families experiencing preterm birth. Content analysis was conducted according to SRQR (Standards for Reporting Qualitative Research) guidelines. Ethics approval was granted by the Women and Newborn Health Service Ethics Committee.</p><p><strong>Results: </strong>Forty-one adults reflected on their life experiences, and 31 included messages for future families. Two predominant themes were (1) neonatal experiences and (2) experiences from childhood and adulthood which were divided into 'positive' and 'negative' subthemes. Participants made 44 references to the neonatal period: 31 (70.5%) 'challenging' including sickness (17, 54.8%), uncertainty (10, 32.3%), family separation (4, 12.9%); and 13 (29.5%) 'positive' including survival (6, 46.2%), support (5, 38.5%), strength (2, 15.4%). Childhood and adulthood was described as 'positive' in 119 (73.5%) references including a good life (41, 33.3%), supportive family (20, 16.3%), success (18, 14.6%), strength (18, 14.6%), gratitude (15, 12.2%), positive self-talk (7, 5.7%); and 'negative' in 43 (26.5%) including health challenges (19, 44.2%), school difficulties (10, 23.3%), family difficulties (9, 20.9%). Messages for future families included what to expect (56, 75.7%) and helpful advice (18, 24.3%).</p><p><strong>Conclusion: </strong>Our preterm-born young adults predominantly describe positive life experiences of childhood and adulthood balanced with an awareness of particular challenges.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delivery room dextrose gel for preterm hypoglycaemia (the GEHPPI study): a randomised placebo-controlled trial.","authors":"Graham King, Julie Sloan, Peter Duddy, Anne O'Sullivan, Niamh Ó Catháin, Jan Miletin, Sharon Dempsey, Shirley Moore, Jyothsna R Purna, Christine McDermott, Margaret Moran, Jean James, Johannes Buca Letshwiti, Kryštof Tabery, Aneta Kubátová, Jan Janota, John Kelleher","doi":"10.1136/archdischild-2024-327313","DOIUrl":"10.1136/archdischild-2024-327313","url":null,"abstract":"<p><strong>Objective: </strong>Early hypoglycaemia at the time of neonatal intensive care unit (NICU) admission is common in very/extreme preterm infants. This study aimed to determine whether buccal dextrose gel in the delivery room (DR) would improve rates of early hypoglycaemia in this population.</p><p><strong>Design: </strong>Randomised, blinded, placebo-controlled trial.</p><p><strong>Setting: </strong>Four level-3 and one level-2 neonatal units.</p><p><strong>Patients: </strong>Inborn infants≤32+0 weeks gestational age (GA).</p><p><strong>Interventions: </strong>Infants were randomised to 40% dextrose or placebo gel in the DR (≤29+0 GA: 0.5 mL gel, ≥29+1 GA: 1 mL gel).</p><p><strong>Main outcome measure: </strong>Hypoglycaemia (<1.8 mmol/L) measured at the time of first intravenous access at NICU admission.</p><p><strong>Results: </strong>Between November 2020 and August 2022, the recruitment rate was slow (impacted by the requirement for antenatal consent). This fact, coupled with finite research resources, led to a decision to end recruitment early. Data analysis of 169 newborns (33% of target sample size) showed no significant difference in the frequency of the primary outcome between dextrose 24/84 (29%) and placebo 25/85 (29%) groups (OR 0.95; 95% CI 0.49 to 1.86; p=0.88). A post-hoc analysis indicated that the trial had a low (47% conditional power) chance of detecting a statistically significant benefit from the intervention (had the target sample been achieved).</p><p><strong>Conclusions: </strong>This study showed no evidence of benefit of 40% dextrose gel on rates of hypoglycaemia at NICU admission. Management of these vulnerable newborns should continue to focus on vascular access and commencement of dextrose-containing intravenous fluids as early as possible.</p><p><strong>Trial registration number: </strong>NCT04353713.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of an oral stimulation protocol on breastfeeding among preterm infants: a randomised controlled trial.","authors":"Gopalakrishnan Jayapradha, Lakshmi Venkatesh, Prakash Amboiram, Radish Kumar Balasubramanium, Umamaheswari Balakrishnan","doi":"10.1136/archdischild-2024-327494","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327494","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives are to assess the effectiveness of a modified and adapted oral sensorimotor intervention (MA-OSMI) protocol for infants in India on the rate and performance of breastfeeding among preterm (PT) infants at discharge.</p><p><strong>Design: </strong>Single-centre randomised control trial.</p><p><strong>Setting: </strong>Level III B neonatal intensive care unit in a quaternary care hospital in South India.</p><p><strong>Patients: </strong>A total of 76 PT infants born between 26 and 33⁺⁶ weeks of gestational age, stratified into <30 weeks and 30-33⁺⁶ weeks, were randomised to intervention group (MA-OSMI) or standard care (SC).</p><p><strong>Interventions: </strong>MA-OSMI in addition to SC versus SC alone. The stimulation included 12 techniques administered by the principal investigator. SC included kangaroo mother care and non-nutritive sucking.</p><p><strong>Outcome measures: </strong>Exclusive breastfeeding (EBF) rate and breastfeeding performance at the time of discharge, assessed using standardised tools by clinician and mothers.</p><p><strong>Results: </strong>Infants in MA-OSMI group (66%) had significantly higher EBF rate compared with the SC group (16%) (OR: 10.25; 95% CI: 3.41 to 30.80). Improved breastfeeding performance was noted as per the clinician's observation. Significantly lower scores for MA-OSMI groups (63.42±36.43) than SC groups (126.61±60.94) on mothers' ratings suggested better feeding skills.</p><p><strong>Conclusion: </strong>Prefeeding oral stimulation contributed significantly to the achievement of EBF among PT infants at discharge. The present findings may benefit speech-language pathologists, paediatricians/neonatologists and nurses in the intervention of oral feeding among neonates.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lingual swelling in a boy aged 4 days due to a foregut duplication cyst.","authors":"Kerri Munn-Bookless, Piers Osborne","doi":"10.1136/archdischild-2024-327574","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327574","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macronutrient concentrations in human milk beyond the first half year of lactation: a cohort study.","authors":"Jacqueline Muts, Juliette I A Lukowski, Jos W R Twisk, Anne Schoonderwoerd, Johannes B van Goudoever, Britt J van Keulen, Chris H P Van Den Akker","doi":"10.1136/archdischild-2024-327319","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327319","url":null,"abstract":"<p><strong>Objective: </strong>Human milk composition is dynamic. While extensive research has focused on its macronutrient concentrations during the first 6 months of lactation, limited research exists for extended lactation periods. This study aims to examine the nutritional composition of human milk during these longer lactation phases.</p><p><strong>Design: </strong>A retrospective longitudinal cohort study performed within the National Dutch Human Milk Bank.</p><p><strong>Participants: </strong>We selected donors who had provided milk donations at least once after the 6-month postpartum mark.</p><p><strong>Main outcome measures: </strong>The Miris Human Milk Analyser was used to analyse macronutrient concentrations in the milk samples. Linear mixed models were used for longitudinal analysis of these concentrations, factoring in time variables established for six sequential lactation periods.</p><p><strong>Results: </strong>We analysed 820 milk samples from 86 women, collected between 5 weeks and 28 months postpartum. Initially, milk protein concentrations dropped over the first 8 months of lactation (diff = -0.19 g/dL, p<0.001) and stabilised between 8 and 18 months before increasing again by 0.21 (95% CI 0.06-0.21) g/dL. Carbohydrate concentrations remained steady throughout the study period. Fat concentrations were stable for the first 8 months but saw an increase afterwards. Post 18 months, the fat content saw a rise of 1.90 (95% CI 1.59-2.21) g/dL. The caloric density mirrored the pattern of the fat concentrations.</p><p><strong>Conclusion: </strong>The nutritional content of human milk does not decrease after 6 months of lactation. Therefore, human milk banks may accept donations from mothers up to 2 years post-birth.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}