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Supplemented vs. unsupplemented human milk on bone mineralization in very low birth weight preterm infants: a randomized clinical trial

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Abstract

Summary

Very low birth weight preterm newborns weighing less than 1500 g were randomized to receive human milk supplemented with FM 85® or not. They have similar bone mineral content (BMC) at baseline, but, at the end of study, BMC was increasingly higher in the FM 85® group.

Introduction

The purpose of this study is to evaluate the effectiveness of a human milk supplement (FM 85®; Nestlé, Vevey, Switzerland) developed for the purpose of improving nutrition, including bone mineralization, in very low birth weight preterm newborns.

Methods

Preterm infants weighing less than 1500 g at birth admitted to the neonatal intensive care unit of a university hospital were studied. During hospitalization, they were fed at least 50 % of human milk. Newborns with ≥20 days of age were randomly assigned to the intervention group (n = 19) to receive human milk supplemented with FM 85® or to a control group (n = 19) to receive human milk only. Anthropometric measurements, whole-body bone densitometry (DXA), and biochemical tests were performed at study entry and at the end of the study (shortly before discharge when the infant had reached 2000 g).

Results

There were no start- or end-of-study differences between the two groups, except for daily increase in length (p = 0.010). At baseline, both groups had similar BMC: 5.49 ± 3.65 vs. 4.34 ± 2.98 g (p = 0.39) for the intervention and control group, respectively. However, at the end of the study, BMC was higher in the intervention group: 10.3 ± 4.71 vs. 6.19 ± 3.23 g (p = 0.003). The mean increase in BMC during the observation period was 4.90 ± 4.46 g for the intervention group and 1.86 ± 3.17 g for the control group (p = 0.020). Serum alkaline phosphatase levels were higher in the control group (720 ± 465 vs. 391 ± 177 IU/L; p = 0.007).

Conclusions

Our data suggest that supplementation of human milk with FM 85® leads to improved bone mineralization in very low birth weight preterm newborns.

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Financial disclosure

The human milk fortifier (FM 85®) was provided by Nestlé Nutrition. Expenses with bone densitometry done at the Department of Densitometry of Hospital São Lucas were also covered by Nestlé Nutrition.

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil

    P. R. Einloft, P. C. R. Garcia, R. Schneider, H. H. Fiori & R. M. Fiori

  2. Pediatric Intensive Care, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil

    P. R. Einloft & P. C. R. Garcia

  3. Rua Curupaiti, 62, 90820-090, Porto Alegre, RS, Brazil

    P. C. R. Garcia

  4. Pediatric Intensive Care, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil

    J. P. Piva

  5. Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil

    J. P. Piva

  6. Institute of Geriatrics and Gerontology, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil

    R. Schneider

  7. Neonatal Intensive Care Unit, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil

    H. H. Fiori & R. M. Fiori

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  1. P. R. Einloft
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Correspondence to P. C. R. Garcia.

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Einloft, P.R., Garcia, P.C.R., Piva, J.P. et al. Supplemented vs. unsupplemented human milk on bone mineralization in very low birth weight preterm infants: a randomized clinical trial. Osteoporos Int 26, 2265–2271 (2015). https://doi.org/10.1007/s00198-015-3144-8

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  • DOI: https://doi.org/10.1007/s00198-015-3144-8

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