THRIVING OF MALNOURISHED
BREASTFED INFANTS AFTER ADDITIONAL FORMULA MILK FEEDING
N. Fidler Mis1, I. Hren1, J. Brecelj2, A. Širca ýampa1, M. Sedmak2, C.
Kržišnik3, B. Koletzko4
1Centre for Nutrition, 2Unit of Gastroenterology, 3Department of Endocrinology, University Children's Hospital, Ljubljana, Slovenia, 44Division Metabolic Diseases and Nutritional Medicine, Dr. von Hauner Children's Hospital, Munich, Germany
Introduction: Breastfeeding is the ideal mode of nutrition for healthy infants, especially during the first months of life. Inadequate breastfeeding may result in critical infant failure to thrive. In such infants it is often necessary to implement nutritional intervention. We studied the efficiency of addition of formula milk to exclusively breastfed infants with failure to thrive, with formula offered after each breastfeeding. We aimed at catch up infant growth and preservation of breastfeeding as much as possible.
Methods: 33 full-term exclusively breast-fed malnourished infants, aged from 28 to 99 days, participated in the study. Insufficient weight gain was defined as
40% expected weight gain for age (600 g/month) and/or body weight 10.
percentile for age (Eurogrowth, 2000). After each breastfeeding, formula milk ff was offered to the infants at libitum, and strategies to preserve breastfeeding were explained to the mother by a paediatrician. Human milk intakes during the first three and the last three days of the study were monitored with the test weighting method. Formula milk intake was registered during the whole study period. Contribution of breastfeeding to total milk intake (CBF, %) wasff calculated as human milk / (human milk + formula milk intake) x 100.
Anthropometric data of the infants were analyzed using Euro Growth program.
Results: Mean (± SD) weight, length and head circumference gains during 31 days of nutritional intervention were 1282 ± 355 g, 4.0 ± 0.9 cm and 2.2 ± 0.9 cm. Absolute human milk intakes (mean ± SD) decreased from 471 ± 181 g/day at study start to 362 ± 282 g/day (study days28-31) (p < 0.05). CBF (mean ± SD) decreased from 100 % at study start to 63 ± 19 % on study days1-3 and 42 ± 35
% on study days28-31 (p < 0.001). Total daily energy intake (human + formula milk) increased from 84 ± 27 kcal/kg at study start to 140 ± 27 kcal/kg during the catch-up growth (study days1-3) and stabilized to 120 ± 24 kcal/kg (study days28-31) (p < 0.001). In the subgroup of 9 infants with the highest contribution of breastfeeding to total milk intake (CBF > 75%) at the beginning of the study,
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THRIVING OF MALNOURISHED BREASTFED INFANTS 175 CBF at study ending (study days 29-31) only slightly decreased to 96% at seven infants, whereas it decreased to 37% at one infant.
Conclusions: Within one month of formula supplementation infants with failure to thrivemm successfully gained weight, while breastfeeding was maintained in most of the infants.
Acknowledgement: Supported by the Ministry of Education, Science and Sport, Republic of Slovenia (project L3-2091).
Key words: malnourished infants, breastfeeding, growth, formula feeding
