Comparison effect of mother milk and donor milk on anthropometric indices and some of preterm newborns` outcomes

Abstract

Abstract: Introduction and purpose: The best nutrition for newborns, especially preterm newborns, is breast milk. The World Health Organization (WHO) has recommended breastfeeding within the first hour of birth and exclusive breastfeeding until the first six months of life. In case ofnot having a sufficient amount of breastmilk to support the nutrition of preterm newborns, human donormilk is often used in neonatal intensive care units (NICUs) and is the best replacement for breast milk to avoid using infant formula. To this end, the current study was designed aimingat comparing breast milk and donor human milk on anthropometric indices and neuromuscular development of preterm newborns. Materials and methods: This study is a prospective cohort study. The target population is30-32 weekspreterm newbornshospitalized in NICUs of Al-Zahra Medical Education Center in Tabriz. A group of newborns who were exclusively breastfed werecompared tonewborns who received more than 50% of their daily needs from donor milk. A number of 90 preterm newborns aged 30-32 weeks were selected observing the inclusion and exclusion criteria and divided into two groups. The researcher entered the newborn's height, weight, and head circumference at the time of birth through the newborn's birth record in the checklist of anthropometric indices. Newborns who had vomiting and abdominal distention after feeding were considered cases of feeding intolerance. The researcher completed the daily checklist related to the incidence of sepsis episodes, necrotizing enterocolitis, and feeding intolerance. At the end of the 10th day, anthropometric indicators were measured again. At the end of the first month (corrected calendar age of the infant), the age and stage (ASQ) questionnaire was completed for the infant. To collect data from the inclusion and the exclusion criteria checklist in this study, parents' personal-social profile questionnaire, newborn anthropometric indices checklist, ASQ questionnaire (one month), NICU hospitalization days checklist and the adverse events checklistare used. For statistical analysis, Kolmogorov-Smirnov, t-test, chi-square and ANCOVA with adjusting the confounding variables were used in SPSS software version 21. Results:The comparison of average weight in the two studied groups at the end of the 10th daydemonstrated that the weight of the newborns who were breastfed was significantly higher than the newborns who received donor milk. The difference between the two groups was significant (p=0.001). However, about the cases of height (p=0.882) and head circumference (p=0.211), this difference was not significant at the end of the 10th day. The occurrence of sepsis, necrotizing enterocolitis, feeding intolerance and usingthe infant formula between the two groups at the end of the 10th day had no statistically significant difference. In the ASQ questionnaire, in the field of communication (P=0.889), fine motor subdomain (P=0.341), problem solving (P=0.470) and personal-social field (P=0.469) in correctional age. At the age of one month, no statistically significant difference was observed between the two groups, only in the area of gross motor (P=0.032) [ adjusted mean difference (95% confidence interval: 0.01 (0.08-1.2)] , statistically there was a significant difference, and the infants who consumed breast milk had a significantly higher score in this area. Conclusion: The results of this study showed that the newborns receiving breast milk had a better weight gain and gross motor than the newborns receiving donated milk. This difference is probably due to changes in the structure of milk during the pasteurization process. According to the results of this study, encouraging breastfeeding for all mothers, especially mothers with preterm newborns, should be a priority of health system decision makers’ planning.