Milk feed osmolality and adverse events in newborn infants and animals: A systematic review
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Milk feed osmolality and adverse events in newborn infants and animals : A systematic review. / Ellis, Zoë Marie; Tan, Hui Shan Grace; Embleton, Nicolas D.; Sangild, Per Torp; Van Elburg, Ruurd M.
In: Archives of Disease in Childhood: Fetal and Neonatal Edition, Vol. 104, No. 3, 2019, p. F333–F340.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Milk feed osmolality and adverse events in newborn infants and animals
T2 - A systematic review
AU - Ellis, Zoë Marie
AU - Tan, Hui Shan Grace
AU - Embleton, Nicolas D.
AU - Sangild, Per Torp
AU - Van Elburg, Ruurd M.
PY - 2019
Y1 - 2019
N2 - Background: High feed osmolality (or osmolarity) is often suggested to be linked with adverse gastrointestinal events in preterm infants. Aim: To systematically review the literature on milk feed osmolality and adverse gastrointestinal events in newborn and low birthweight infants and animals. Methods: MEDLINE, Embase, CAB Abstracts, Current Contents, BIOSIS Previews and SciSearch were searched from inception to May 2018 to identify potentially relevant studies. Inclusion criteria: randomised controlled or observational studies of newborn and low birthweight infants or animals investigating the effects of milk-based feeds with different osmolalities. Only full-text, English-language papers were included. Results: Ten human and six animal studies met the inclusion criteria. Of human studies, seven reported no differences in adverse events with varying feed osmolalities; one reported delayed gastric emptying with feed osmolarity of 539 mOsm/L compared with lower levels; one reported higher necrotising enterocolitis (NEC) incidence with feed osmolarity of 650 mOsm/L compared with 359 mOsm/L; one found higher NEC incidence with the lowest feed osmolality (326 mOsm/kg compared with 385 mOsm/kg). Of animal studies, two reported delayed gastric emptying with feed osmolarity >624 mOsm/L, one reported decreased survival due to dehydration with dietary osmolarities ≥765 mOsmol/L and none reported increased NEC incidence with differing feed osmolalities. No clear mechanisms were found, and diet composition differences limited the interpretations regarding the independent impact of osmolality. Conclusions: There is no consistent evidence that differences in feed osmolality in the range 300-500 mOsm/kg are associated with adverse gastrointestinal symptoms in neonates.
AB - Background: High feed osmolality (or osmolarity) is often suggested to be linked with adverse gastrointestinal events in preterm infants. Aim: To systematically review the literature on milk feed osmolality and adverse gastrointestinal events in newborn and low birthweight infants and animals. Methods: MEDLINE, Embase, CAB Abstracts, Current Contents, BIOSIS Previews and SciSearch were searched from inception to May 2018 to identify potentially relevant studies. Inclusion criteria: randomised controlled or observational studies of newborn and low birthweight infants or animals investigating the effects of milk-based feeds with different osmolalities. Only full-text, English-language papers were included. Results: Ten human and six animal studies met the inclusion criteria. Of human studies, seven reported no differences in adverse events with varying feed osmolalities; one reported delayed gastric emptying with feed osmolarity of 539 mOsm/L compared with lower levels; one reported higher necrotising enterocolitis (NEC) incidence with feed osmolarity of 650 mOsm/L compared with 359 mOsm/L; one found higher NEC incidence with the lowest feed osmolality (326 mOsm/kg compared with 385 mOsm/kg). Of animal studies, two reported delayed gastric emptying with feed osmolarity >624 mOsm/L, one reported decreased survival due to dehydration with dietary osmolarities ≥765 mOsmol/L and none reported increased NEC incidence with differing feed osmolalities. No clear mechanisms were found, and diet composition differences limited the interpretations regarding the independent impact of osmolality. Conclusions: There is no consistent evidence that differences in feed osmolality in the range 300-500 mOsm/kg are associated with adverse gastrointestinal symptoms in neonates.
KW - infant feeding
KW - neonatology
KW - nutrition
KW - osmolality
KW - tolerance
U2 - 10.1136/archdischild-2018-315946
DO - 10.1136/archdischild-2018-315946
M3 - Review
C2 - 30523072
AN - SCOPUS:85058303688
VL - 104
SP - F333–F340
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
SN - 0003-9888
IS - 3
ER -
ID: 217947592