TY - JOUR
T1 - Breast milk is better than formula milk in preventing parenteral nutrition-associated liver disease in infants receiving prolonged parenteral nutrition
AU - Kulkarni, Sakil
AU - Mercado, Velma
AU - Rios, Mirta
AU - Arboleda, Richard
AU - Gomara, Roberto
AU - Muinos, William
AU - Reeves-Garcia, Jesse
AU - Hernandez, Erick
PY - 2013/9
Y1 - 2013/9
N2 - Background and Aim: Breast milk has been shown to be associated with greater success with regard to weaning children with intestinal failure off parenteral nutrition (PN). There are only a few studies investigating the role of breast milk in decreasing PN-associated liver disease (PNALD). The aim of our study was to determine whether breast milk is better than formula milk in preventing PNALD in infants receiving PN for >4 weeks. Methods: We conducted a retrospective analysis of newborns requiring prolonged parenteral nutrition. We divided the sample into 3 different groups (exclusive breast-feeding, exclusive formula-feeding, and mixed feeding. We compared baseline characteristics, feeding profiles and liver function tests, and liver enzymes among the 3 groups. Results: Among infants receiving PN for >4 weeks, we found that infants who were fed only breast milk were significantly less likely to develop PNALD (34.6%) compared with those who were fed only formula milk (72.7%; P=0.008). The mean maximum conjugated bilirubin (P=0.03) and the mean maximum aspartate aminotransferase were significantly lower in the breast-fed group (P=0.04) compared with the formula-fed group. Among the mixed-feeding group, infants who received a higher percentage of breast milk showed a significant negative correlation with the mean maximum conjugated bilirubin. (Pearson correlation -0.517, P=0.027). The mean number of days receiving PN and the average daily lipid intake in the 2 groups was not significantly different. Conclusions: As a modality for early enteral nutrition, breast milk is protective against the development of PNALD in infants receiving PN for >4 weeks.
AB - Background and Aim: Breast milk has been shown to be associated with greater success with regard to weaning children with intestinal failure off parenteral nutrition (PN). There are only a few studies investigating the role of breast milk in decreasing PN-associated liver disease (PNALD). The aim of our study was to determine whether breast milk is better than formula milk in preventing PNALD in infants receiving PN for >4 weeks. Methods: We conducted a retrospective analysis of newborns requiring prolonged parenteral nutrition. We divided the sample into 3 different groups (exclusive breast-feeding, exclusive formula-feeding, and mixed feeding. We compared baseline characteristics, feeding profiles and liver function tests, and liver enzymes among the 3 groups. Results: Among infants receiving PN for >4 weeks, we found that infants who were fed only breast milk were significantly less likely to develop PNALD (34.6%) compared with those who were fed only formula milk (72.7%; P=0.008). The mean maximum conjugated bilirubin (P=0.03) and the mean maximum aspartate aminotransferase were significantly lower in the breast-fed group (P=0.04) compared with the formula-fed group. Among the mixed-feeding group, infants who received a higher percentage of breast milk showed a significant negative correlation with the mean maximum conjugated bilirubin. (Pearson correlation -0.517, P=0.027). The mean number of days receiving PN and the average daily lipid intake in the 2 groups was not significantly different. Conclusions: As a modality for early enteral nutrition, breast milk is protective against the development of PNALD in infants receiving PN for >4 weeks.
KW - alanine aminotransferase
KW - aspartate aminotransferase
KW - breast milk
KW - enteral nutrition
KW - parenteral nutrition
KW - parenteral nutrition-associated liver disease
UR - http://www.scopus.com/inward/record.url?scp=84883743307&partnerID=8YFLogxK
U2 - 10.1097/MPG.0b013e31829b68f3
DO - 10.1097/MPG.0b013e31829b68f3
M3 - Article
C2 - 23689264
AN - SCOPUS:84883743307
SN - 0277-2116
VL - 57
SP - 383
EP - 388
JO - Journal of pediatric gastroenterology and nutrition
JF - Journal of pediatric gastroenterology and nutrition
IS - 3
ER -