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Fatty acid concentrations in preterm infants fed the exclusive human milk diet: a prospective cohort study

Journal of Perinatology volume 44, pages 680–686 (2024)Cite this article

Subjects

Abstract

Objective

Quantify blood fatty acids and growth outcomes in preterm infants fed the exclusive human milk diet.

Methods

A prospective cohort study of 30 infants 24–34 weeks gestation and ≤1250 g fed the exclusive human milk diet. Blood fatty acids were quantified at two time points. Comparisons were made using two-sample t-tests and Wilcoxon rank sum.

Results

Donor human milk-fed (n = 12) compared to mother’s own milk-fed infants (n = 18) from birth to after 28 days of life, had an increased interval change of linoleic to docosahexaenoic acid ratio (5.5 vs. −1.1 mole percent ratio, p = 0.034). Docosahexaenoic and eicosapentaenoic acid interval changes were similar between groups. The arachidonic acid change was similar between groups (−2.3 vs. −0.9 mole percent, p = 0.37), however, both experienced a negative change across time. At 36 weeks postmenstrual age, growth velocities were similar for groups.

Conclusion

An exclusive human milk diet maintains birth docosahexaenoic and eicosapentaenoic acid concentrations. However, the postnatal deficit in arachidonic acid was not prevented.

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Fig. 1
Fig. 2
Fig. 3: Fatty acid values for all cohorts, majority base milk type (>70%), and use of cream from birth to after postnatal day 28.

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Data availability

If requested, I will provide the de-identified data used in this manuscript, the code book, and the analytic code to the editors.

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Acknowledgements

The authors thank the nursing staff of Texas Children’s Hospital neonatal intensive care unit and the parents of our preterm infants who were critical in ensuring the successful completion of this study. Supported by the Evie Whitlock Foundation Grant for fellows in Neonatal-Perinatal Medicine at Baylor College of Medicine. The authors would also like to thank the following people for their invaluable assistance with the project: Kristina Tucker, BSN, RNC-LRN, Nelly Zavala, Texas Children’s Hospital Neonatal Dietitians and Milk Bank Technicians.

Funding

LFH received research support from the Baylor College of Medicine Evangelina “Evie” Whitlock Fellowship Award in Neonatology, Houston, TX, and the Texas Children’s Hospital Clinical Research Center. She received no outside funding for this study. All other others did not contribute funding to this study.

Author information

Author notes

  1. These authors contributed equally: Amy B. Hair, Camilia R. Martin.

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, McGovern Medical School at the University of Texas Health Science Center at Houston, Children’s Memorial Hermann Hospital, Houston, TX, USA

    Lindsay F. Holzapfel

  2. Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA

    Lindsay F. Holzapfel, Jana P. Unger, Pam Gordon, Heeju Yang, Laura A. Gollins & Amy B. Hair

  3. Clinical Research Nutrition Center, Texas Children’s Hospital, Houston, TX, USA

    Pam Gordon

  4. Department of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA

    Joanne E. Cluette-Brown

  5. Division of Neonatology, Weill Cornell Medicine, New York, NY, USA

    Camilia R. Martin

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  1. Lindsay F. Holzapfel
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Contributions

Conceptualization: LFH, ABH and CRM; methodology: LFH, ABH and CRM; formal analysis: LFH, ABH and CRM; investigation: LFH, JPU, PG, HY, JEC-B, ABH and CRM; data curation: LFH, JPU, PG, HY and JEC-B; writing—original draft preparation: LFH; writing—review and editing: LFH, JPU, PG, HY, JEC-B, LAG, ABH and CRM; supervision: LFH, ABH and CRM; project administration: LFH, JPU and HY; funding acquisition: LFH.

Corresponding author

Correspondence to Lindsay F. Holzapfel.

Ethics declarations

Competing interests

CRM serves on the advisory board of LactaLogics, Plakous Therapeutics, and Vitara Biomedical. All other authors declare no conflict of interest.

Ethical approval

All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work. The Institutional Review Board at Baylor College of Medicine, Texas Children’s Hospital in Houston, TX, approved this study (Protocol H-43075). Informed written consent was obtained.

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Holzapfel, L.F., Unger, J.P., Gordon, P. et al. Fatty acid concentrations in preterm infants fed the exclusive human milk diet: a prospective cohort study. J Perinatol 44, 680–686 (2024). https://doi.org/10.1038/s41372-023-01841-y

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