642 - Body Composition in Low Birth Weight Preterm Infants Fed Mother's Own Milk vs. Donor's Breast Milk

Publication Number: 1619.642

Stephanie M. Chavez, university of south florida, Tampa, FL, United States; Vanessa Riley, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States; Sophia Estrada, Tampa General Hospital Children's Medical Center, Brandon, FL, United States; Manda Mainville, USF Health Morsani College of Medicine, Tampa, FL, United States; Ambuj Kumar, University Of South, Tampa, FL, United States; Steven Ford, USF Health Morsani College of Medicine, Tampa, FL, United States

Background: Feeding mother’s own milk (MOM) to preterm infants is associated with increased fat-free mass accretion compared to infants feeding formula, which is linked to enhanced metabolic and neurodevelopmental outcomes. Donor breast milk (DBM) is often utilized when the supply of MOM is insufficient. DBM offers protective benefits against necrotizing enterocolitis compared to formula, but its pasteurization reduces many of the potential advantages of feeding MOM. Limited data exists regarding body composition among donor milk-fed preterm infants.

Objective: To assess body mass composition among preterm infants primarily fed MOM compared with those receiving mostly DBM.

Design/Methods: This is an IRB-approved single-center prospective cohort study. Eligible infants include those born at less than or equal to 32 weeks' gestation or birth weight less than or equal to 2000 grams. Infants are grouped based on the predominant type of feeding, MOM or DBM/formula, with a cut-off of >50% MOM received from birth to date of measurement. Body composition is measured via air displacement plethysmography (ADP) via the PeaPod® system at 36 weeks corrected gestational age or discharge.

Results: 103 infants have been included in this study. The mean gestational age (weeks) for infants was 30 (± 3) and 30 (±2.4) weeks in the MBM and DBM groups respectively (p=0.74). MBM-fed infants were more likely to have mothers who identified as Caucasian (66.2%, p= < 0.05); other maternal demographic data did not differ between the two groups. Weight Z-scores at birth were lower in the DBM cohort (p= < 0.05). Clinical outcomes were similar among both cohorts. The DBM group received significantly higher estimated protein intake compared to the MBM group (3.6 g/kg/day vs. 2.8 g/kg/day, p= < 0.05). At the time of body composition measurement, the DBM group had significantly shorter length, however there was no significant difference in the change in length since birth. There was no significant difference in the fat mass % or fat-free mass % measured for either group.

Conclusion(s): While DBM-fed infants had shorter length at 36 weeks’ corrected age, there was no difference in the primary outcomes of fat mass or fat-free mass composition between the two groups. There was also no difference in the change in weight Z-score since birth. Of note, the DBM group received significantly higher estimated protein intake, presumably from increased supplementation. As infants in our unit are individually fortified, this may have compensated for faltering growth and lean mass accretion. Our sample size may have limited our ability to confirm this hypothesis.