Human Milk-Derived Fortifier to Reduce Hospital-Acquired Malnutrition in Uncomplicated Gastroschisis: A Case Report
Gastroschisis is one of the most common congenital gastrointestinal disorders, occurring in about one in 1,953 infants born each year in the United States. Infants with gastroschisis rely on total parenteral nutrition (TPN) preoperatively, and due to intestinal function and dysmotility issues, conti...
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Thieme Medical Publishers, Inc.
2024-07-01
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| Series: | American Journal of Perinatology Reports |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2490-3521 |
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| author | Anna Strle Sarah M. Reyes Megan Schmidt Mary Frances Lynch |
| author_facet | Anna Strle Sarah M. Reyes Megan Schmidt Mary Frances Lynch |
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| description | Gastroschisis is one of the most common congenital gastrointestinal disorders, occurring in about one in 1,953 infants born each year in the United States. Infants with gastroschisis rely on total parenteral nutrition (TPN) preoperatively, and due to intestinal function and dysmotility issues, continue to face feeding challenges postclosure, including feeding intolerance and increased risk of necrotizing enterocolitis (NEC). Postclosure, human milk-feeding is preferred over infant formula because of its associated reduced risk of feeding intolerance and NEC. However, unfortified human milk often falls short of meeting the increased metabolic demands of these postsurgical infants in the first few weeks of life, leading to hospital-acquired malnutrition (undernutrition) as TPN is weaned. We hypothesized that fortifying maternal milk with human milk-based fortifiers would mitigate the risk of hospital-acquired malnutrition while providing the tolerance benefits of an exclusive human milk diet, specifically by meeting the increased energy and protein demands of the immediate postsurgical infant as parenteral nutrition is weaned. The case report describes our unit's use of a human milk-based fortifier in an infant with uncomplicated gastroschisis and its positive effect on the patient's growth. Further research is warranted to assess the use of human milk-derived fortifiers to prevent hospital-acquired malnutrition after gastrointestinal surgery. |
| format | Article |
| id | doaj-art-a27ee23f79c340f68e7e9e9532aefc4f |
| institution | Kabale University |
| issn | 2157-6998 2157-7005 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | American Journal of Perinatology Reports |
| spelling | doaj-art-a27ee23f79c340f68e7e9e9532aefc4f2024-12-23T23:55:52ZengThieme Medical Publishers, Inc.American Journal of Perinatology Reports2157-69982157-70052024-07-011404e275e28010.1055/a-2490-3521Human Milk-Derived Fortifier to Reduce Hospital-Acquired Malnutrition in Uncomplicated Gastroschisis: A Case ReportAnna Strle0Sarah M. Reyes1https://orcid.org/0000-0001-5804-4338Megan Schmidt2Mary Frances Lynch3Neonatal Intensive Care Unit, Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, TexasRev Bioscience, LLC, Boise, IdahoNeonatal Intensive Care Unit, Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, TexasNeonatal Intensive Care Unit, Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, TexasGastroschisis is one of the most common congenital gastrointestinal disorders, occurring in about one in 1,953 infants born each year in the United States. Infants with gastroschisis rely on total parenteral nutrition (TPN) preoperatively, and due to intestinal function and dysmotility issues, continue to face feeding challenges postclosure, including feeding intolerance and increased risk of necrotizing enterocolitis (NEC). Postclosure, human milk-feeding is preferred over infant formula because of its associated reduced risk of feeding intolerance and NEC. However, unfortified human milk often falls short of meeting the increased metabolic demands of these postsurgical infants in the first few weeks of life, leading to hospital-acquired malnutrition (undernutrition) as TPN is weaned. We hypothesized that fortifying maternal milk with human milk-based fortifiers would mitigate the risk of hospital-acquired malnutrition while providing the tolerance benefits of an exclusive human milk diet, specifically by meeting the increased energy and protein demands of the immediate postsurgical infant as parenteral nutrition is weaned. The case report describes our unit's use of a human milk-based fortifier in an infant with uncomplicated gastroschisis and its positive effect on the patient's growth. Further research is warranted to assess the use of human milk-derived fortifiers to prevent hospital-acquired malnutrition after gastrointestinal surgery.http://www.thieme-connect.de/DOI/DOI?10.1055/a-2490-3521malnutritioncase reporthuman milkhuman milk fortifiergastroschisis |
| spellingShingle | Anna Strle Sarah M. Reyes Megan Schmidt Mary Frances Lynch Human Milk-Derived Fortifier to Reduce Hospital-Acquired Malnutrition in Uncomplicated Gastroschisis: A Case Report American Journal of Perinatology Reports malnutrition case report human milk human milk fortifier gastroschisis |
| title | Human Milk-Derived Fortifier to Reduce Hospital-Acquired Malnutrition in Uncomplicated Gastroschisis: A Case Report |
| title_full | Human Milk-Derived Fortifier to Reduce Hospital-Acquired Malnutrition in Uncomplicated Gastroschisis: A Case Report |
| title_fullStr | Human Milk-Derived Fortifier to Reduce Hospital-Acquired Malnutrition in Uncomplicated Gastroschisis: A Case Report |
| title_full_unstemmed | Human Milk-Derived Fortifier to Reduce Hospital-Acquired Malnutrition in Uncomplicated Gastroschisis: A Case Report |
| title_short | Human Milk-Derived Fortifier to Reduce Hospital-Acquired Malnutrition in Uncomplicated Gastroschisis: A Case Report |
| title_sort | human milk derived fortifier to reduce hospital acquired malnutrition in uncomplicated gastroschisis a case report |
| topic | malnutrition case report human milk human milk fortifier gastroschisis |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2490-3521 |
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