The impact of timing for initiating formula feeding on the short-term prognosis of very low birth weight infants

Background: For very low birth weight (VLBW) infants, breast milk, particularly mothers' own milk (MOM), is the optimal nutrition. Donor human milk (DHM) is recommended when MOM is insufficient. However, the optimal timing for transitioning from DHM to formula remains unclear. This study examin...

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Main Author: Katsumi Mizuno
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Global Pediatrics
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Online Access:http://www.sciencedirect.com/science/article/pii/S266700972500017X
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author Katsumi Mizuno
author_facet Katsumi Mizuno
author_sort Katsumi Mizuno
collection DOAJ
description Background: For very low birth weight (VLBW) infants, breast milk, particularly mothers' own milk (MOM), is the optimal nutrition. Donor human milk (DHM) is recommended when MOM is insufficient. However, the optimal timing for transitioning from DHM to formula remains unclear. This study examines the impact of formula initiation timing on complications in VLBW infants. Methods: We analyzed data from 744 VLBW infants (<1500 g) who initiated enteral feeding with DHM within 24 hours of birth using a human milk bank database (2018–2024). Postmenstrual age (PMA) at formula initiation was assessed for associations with bronchopulmonary dysplasia (BPD), home oxygen therapy (HOT), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC). Results: The median PMA at formula initiation was 34.6 weeks. Delayed formula initiation reduced the risk of BPD, HOT, and NEC. Compared to formula initiation before 32 weeks, odds ratios for BPD ranged from 0.186 (34–36 weeks) to 0.239 (no formula). Formula initiation at 32–34 weeks significantly lowered ROP requiring treatment (OR 0.305). Logistic regression analysis indicated a trend toward reduced NEC risk when formula initiation occurred after 34 weeks (p = 0.0504). Conclusion: Delaying formula initiation until after 34 weeks PMA reduces complications in VLBW infants. Early enteral nutrition with MOM or DHM within 24 hours of birth is crucial, and later formula introduction may provide better outcomes. Further studies are needed to refine feeding guidelines
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spelling doaj-art-206c0087e4be4fb8a94e3309b5eda2f32025-08-20T03:48:14ZengElsevierGlobal Pediatrics2667-00972025-06-011210025910.1016/j.gpeds.2025.100259The impact of timing for initiating formula feeding on the short-term prognosis of very low birth weight infantsKatsumi Mizuno0Corresponding author.; Showa University School of Medicine, Department of Pediatrics, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, JapanBackground: For very low birth weight (VLBW) infants, breast milk, particularly mothers' own milk (MOM), is the optimal nutrition. Donor human milk (DHM) is recommended when MOM is insufficient. However, the optimal timing for transitioning from DHM to formula remains unclear. This study examines the impact of formula initiation timing on complications in VLBW infants. Methods: We analyzed data from 744 VLBW infants (<1500 g) who initiated enteral feeding with DHM within 24 hours of birth using a human milk bank database (2018–2024). Postmenstrual age (PMA) at formula initiation was assessed for associations with bronchopulmonary dysplasia (BPD), home oxygen therapy (HOT), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC). Results: The median PMA at formula initiation was 34.6 weeks. Delayed formula initiation reduced the risk of BPD, HOT, and NEC. Compared to formula initiation before 32 weeks, odds ratios for BPD ranged from 0.186 (34–36 weeks) to 0.239 (no formula). Formula initiation at 32–34 weeks significantly lowered ROP requiring treatment (OR 0.305). Logistic regression analysis indicated a trend toward reduced NEC risk when formula initiation occurred after 34 weeks (p = 0.0504). Conclusion: Delaying formula initiation until after 34 weeks PMA reduces complications in VLBW infants. Early enteral nutrition with MOM or DHM within 24 hours of birth is crucial, and later formula introduction may provide better outcomes. Further studies are needed to refine feeding guidelineshttp://www.sciencedirect.com/science/article/pii/S266700972500017XDonor human milkNecrotizing enterocolitisBronchopulmonary dysplasiaHome oxygen therapy
spellingShingle Katsumi Mizuno
The impact of timing for initiating formula feeding on the short-term prognosis of very low birth weight infants
Global Pediatrics
Donor human milk
Necrotizing enterocolitis
Bronchopulmonary dysplasia
Home oxygen therapy
title The impact of timing for initiating formula feeding on the short-term prognosis of very low birth weight infants
title_full The impact of timing for initiating formula feeding on the short-term prognosis of very low birth weight infants
title_fullStr The impact of timing for initiating formula feeding on the short-term prognosis of very low birth weight infants
title_full_unstemmed The impact of timing for initiating formula feeding on the short-term prognosis of very low birth weight infants
title_short The impact of timing for initiating formula feeding on the short-term prognosis of very low birth weight infants
title_sort impact of timing for initiating formula feeding on the short term prognosis of very low birth weight infants
topic Donor human milk
Necrotizing enterocolitis
Bronchopulmonary dysplasia
Home oxygen therapy
url http://www.sciencedirect.com/science/article/pii/S266700972500017X
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