Premature Infants 750-1,250 g Birth Weight Supplemented with a Novel Human Milk-Derived Cream Are Discharged Sooner

Objective: Infants may benefit from early nutritional intervention to decrease hospital stay. To evaluate the effects of adding a human milk (HM)-derived cream (Cream) product to a standard feeding regimen in preterm infants. Materials and Methods: In a prospective multicenter randomized study, infants with birth weights 750-1,250 g were assigned to a Control or Cream group. The Control group received a standard feeding regimen consisting of mother's own milk or donor HM with donor HM-derived fortifier. The Cream group received the standard feeding regimen along with an additional HM-derived cream supplement when the HM they received was <20 kcal/oz. Primary outcomes of this secondary analysis included comorbidities, length of stay (LOS), and postmenstrual age (PMA) at discharge. Results: We enrolled 75 infants (Control n = 37, Cream n = 38) with gestational age 27.7 +/- 1.8 weeks and birth weight 973 +/- 145 g (mean +/- SD). After adjusting for gestational age, birth weight, and presence of bronchopulmonary dysplasia (BPD), the Cream group had a decreased PMA at discharge (39.9 +/- 4.8 versus 38.2 +/- 2.7 weeks, p = 0.03) and LOS (86 +/- 39 versus 74 +/- 22 days, p = 0.05). For 21 infants with BPD, these values trended toward significance for PMA at discharge (44.2 +/- 6.1 versus 41.3 +/- 2.7 weeks, p = 0.08) and LOS (121 +/- 49 versus 104 +/- 23 days, p = 0.08). Conclusions: Very preterm infants who received an HM-derived cream supplement were discharged earlier. Infants with BPD may have benefited the most.