Document Detail

Protein content and fortification of human milk influence gastroesophageal reflux in preterm infants.
MedLine Citation:
PMID:  19633575     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES:: Preterm human milk (HM) may provide insufficient energy and nutrients and thus may need to be fortified. Our aim was to determine whether fat content, protein content, and osmolality of HM before and after fortification may affect gastroesophageal reflux (GER) in symptomatic preterm infants. METHODS:: Gastroesophageal reflux was evaluated in 17 symptomatic preterm newborns fed na?ve and fortified HM by combined pH/intraluminal-impedance monitoring (pH-MII). Human milk fat and protein content was analysed by a near-infrared reflectance analysis. Human milk osmolality was tested before and after fortification. Gastroesophageal reflux indexes measured before and after fortification were compared and were also related to HM fat and protein content and osmolality before and after fortification. RESULTS:: An inverse correlation was found between na?ve HM protein content and acid reflux index (RIpH: P = 0.041, rho =-0.501). After fortification, osmolality often exceeded the values recommended for infant feeds; furthermore, a statistically significant (P < 0.05) increase in nonacid reflux indexes was observed. CONCLUSIONS:: Protein content of na?ve HM may influence acid GER in preterm infants. A standard fortification of HM may worsen nonacid GER indexes and, due to the extreme variability in HM composition, may overcome both recommended protein intake and HM osmolality. Thus, an individualised fortification, based on the analysis of the composition of na?ve HM, could optimise both nutrient intake and feeding tolerance.
Arianna Aceti; Luigi Corvaglia; Vittoria Paoletti; Elisa Mariani; Gina Ancora; Silvia Galletti; Giacomo Faldella
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  49     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-27     Completed Date:  2010-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  613-8     Citation Subset:  IM    
Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy.
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MeSH Terms
Dietary Proteins / analysis,  pharmacology,  therapeutic use*
Electric Impedance
Esophageal pH Monitoring
Food, Fortified*
Gastroesophageal Reflux / diet therapy*
Infant Nutritional Physiological Phenomena
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / diet therapy*
Milk, Human / chemistry*
Osmolar Concentration
Severity of Illness Index
Reg. No./Substance:
0/Dietary Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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