TY - JOUR

T1 - A Randomized, Controlled Study to Investigate How Bovine Colostrum Fortification of Human Milk Affects Bowel Habits in Preterm Infants (FortiColos Study)

AU - Kappel, Susanne Soendergaard

AU - Sangild, Per Torp

AU - Ahnfeldt, Agnethe May

AU - Johannsdottir, Valdis

AU - Soernsen, Line Juul

AU - Bak, Lene Boejgaard

AU - Friborg, Christel

AU - Moller, Soren

AU - Zachariassen, Gitte

AU - Aunsholt, Lise

PY - 2022

Y1 - 2022

N2 - Background: Human milk does not meet the nutritional needs to support optimal growth of very preterm infants during the first weeks of life. Nutrient fortifiers are therefore added to human milk, though these products are suspected to increase gut dysmotility. The objective was to evaluate whether fortification with bovine colostrum (BC) improves bowel habits compared to a conventional fortifier (CF) in very preterm infants. Methods: In an unblinded, randomized study, 242 preterm infants (26-31 weeks of gestation) were randomized to receive BC (BC, Biofiber Damino, Gesten, Denmark) or CF (FM85 PreNAN, Nestle, Vevey, Switzerland) as a fortifier. Stools (Amsterdam Stool Scale), bowel gas restlessness, stomach appearance score, volume, and frequency of gastric residuals were recorded before each meal until 35 weeks post-menstrual age. Results: As intake of fortifiers increased, stools became harder in both groups (p < 0.01) though less in BC infants (p < 0.05). The incidence of bowel gas restlessness increased with laxative treatments and days of fortification in both groups (p < 0.01), but laxatives were prescribed later in BC infants (p < 0.01). With advancing age, stomach appearance scores improved, but more so in BC infants (p < 0.01). Conclusions: Although there are limitations, a minimally processed, bioactive milk product such as BC induced similar or slightly improved bowel habits in preterm infants.

AB - Background: Human milk does not meet the nutritional needs to support optimal growth of very preterm infants during the first weeks of life. Nutrient fortifiers are therefore added to human milk, though these products are suspected to increase gut dysmotility. The objective was to evaluate whether fortification with bovine colostrum (BC) improves bowel habits compared to a conventional fortifier (CF) in very preterm infants. Methods: In an unblinded, randomized study, 242 preterm infants (26-31 weeks of gestation) were randomized to receive BC (BC, Biofiber Damino, Gesten, Denmark) or CF (FM85 PreNAN, Nestle, Vevey, Switzerland) as a fortifier. Stools (Amsterdam Stool Scale), bowel gas restlessness, stomach appearance score, volume, and frequency of gastric residuals were recorded before each meal until 35 weeks post-menstrual age. Results: As intake of fortifiers increased, stools became harder in both groups (p < 0.01) though less in BC infants (p < 0.05). The incidence of bowel gas restlessness increased with laxative treatments and days of fortification in both groups (p < 0.01), but laxatives were prescribed later in BC infants (p < 0.01). With advancing age, stomach appearance scores improved, but more so in BC infants (p < 0.01). Conclusions: Although there are limitations, a minimally processed, bioactive milk product such as BC induced similar or slightly improved bowel habits in preterm infants.

KW - nutrition

KW - preterm infant

KW - fortifier

KW - bowel habits

KW - laxative

KW - FUNCTIONAL GASTROINTESTINAL DISORDERS

KW - FEEDING INTOLERANCE

KW - GASTRIC RESIDUALS

KW - NECROTIZING ENTEROCOLITIS

KW - PREMATURE-INFANTS

KW - FORMULA

KW - GUT

KW - OBSTRUCTION

KW - LAXATIVES

KW - MOTILITY

U2 - 10.3390/nu14224756

DO - 10.3390/nu14224756

M3 - Journal article

C2 - 36432444

VL - 14

JO - Nutrients

JF - Nutrients

SN - 2072-6643

IS - 22

M1 - 4756

ER -