Patient characteristics during feeding protocol changes
| Epoch 1: Baseline (September 2015 – April 2016) N=51 (12%) | Epoch 2: Introduction of Donor Breast Milk (DBM) (May 2016 – June 2018) N=102 (24%) | Epoch 3: Stopped routine gastric aspirates (July 2018 – October 2020) N=108 (26%) | Epoch 4: Introduction of Human-milk-based fortifier (November 2018 – December 2020) N=161 (38%) | p-value | |
|---|---|---|---|---|---|
| Female Sex | 29 (57%) | 51 (50%) | 49 (45%) | 88 (55%) | 0.8344 |
| Birth GA (weeks), mean (SD) | 27.5 (2.8) | 28.1 (2.6) | 27.5 (2.7) | 28 (2.6) | 0.3346 |
| Birth Weight (grams), mean (SD) | 913 (214) | 919 (200) | 896 (225) | 942 (192) | 0.3478 |
| Race: Non-Hispanic White Race: Non-Hispanic Black | 18 (37%) 28 (57%) | 35 (34%) 55 (54%) | 34 (31%) 60 (56%) | 37 (23%) 104 (65%) | 0.2573 |
| No antenatal steroids | 5 (10%) | 5 (5%) | 7 (6%) | 11 (7%) | 0.5110 |
| SGA (<10%tile) | 11 (22%) | 39 (39%) | 35 (32%) | 55 (34%) | 0.1795 |
| DOL first feed, median (IQR) | 3.5 (2-7) | 3 (2-5) | 3 (2-5) | 2 (1-3) | <0.0001 |
| DOL first Maternal Breast Milk (MBM), median (IQR) | 4 (3-9) | 3 (2-4) | 3 (2-5) | 2 (1-3) | <0.0001 |
| DOL full feeds (150ml/kg/day), median (IQR) | 21 (17-36) | 21 (15-36) | 19 (15-40) | 16 (11-30) | 0.0003 |
| DOL started first formula, median (IQR) | 23 (10-48) | 38 (25-59) | 47 (33-62) | 38 (23-51) | 0.0007 |
| Ever received MBM | 43 (84%) | 92 (91%) | 93 (87%) | 142 (88%) | 0.6365 |
| Received Donor Breast Milk (DBM) | 0 (0%) | 39 (39%) | 52 (50%) | 90 (57%) | <0.0001 |
| Received Human-milk-based human-milk fortifier (HMBHMF) | 0 (0%) | 0 (0%) | 0 (0%) | 113 (71%) | <0.0001 |
| Ever received formula | 36 (72%) | 73 (72%) | 78 (73%) | 89 (56%) | 0.0089 |
| NEC (any Bell stage 1-3) | 7 (14%) | 18 (18%) | 15 (14%) | 17 (11%) | 0.4498 |
| NEC Stage 2 or 3 | 2 (3.9%) | 11 (11%) | 9 (8%) | 6 (3.7%) | 0.1049 |
| UVC placed | 40 (78%) | 86 (84%) | 88 (81%) | 129 (80%) | 0.7932 |
| PICC or surgical CVL placed | 46 (94%) | 92 (90%) | 94 (88%) | 126 (78%) | 0.0080 |
| DOL all central lines removed, median (IQR) | 21 (17-43) | 22.5 (15-44.5) | 19 (14.5-41.5) | 15 (11-26) | <0.0001 |
| DOL last parenteral nutrition, median (IQR) | 23 (17-41) | 23 (16-52) | 26 (15-58.5) | 18 (11-34) | 0.0008 |
| IVH Grade III/IV | 3 (6%) | 6 (6%) | 15 (14%) | 12 (7%) | 0.5275 |
| Periventricular leukomalacia (PVL) | 2 (4%) | 7 (7%) | 18 (17%) | 10 (6%) | 0.0104 |
| ROP requiring treatment | 3 (8%) | 4 (5%) | 6 (6%) | 4 (3%) | 0.6969 |
| Late onset sepsis (blood culture positive) | 2 (4%) | 8 (8%) | 11 (10%) | 23 (14%) | 0.1269 |
| FiO2 >21% at 36 weeks PMA | 31 (61%) | 58 (57%) | 62 (57%) | 69 (44%) | 0.0427 |
| Spontaneous intestinal perforation (SIP) | 1 (2%) | 6 (6%) | 5 (5%) | 6 (4%) | 0.6933 |
| Death prior to discharge | 4 (8%) | 4 (4%) | 3 (3%) | 10 (6%) | 0.4229 |
| Daily weight gain, birth to 4 weeks of life (g/kg/day), median (IQR) | 14 (11-19) | 15 (10-21) | 15 (10-20) | 13 (9-18) | 0.1043 |
| Daily weight gain, birth to 6 weeks of life (g/kg/day), median (IQR) | 19 (14-22) | 19 (13-23) | 19 (14-23) | 17 (13-21) | 0.1847 |
DOL, day of life; HMBHMF, human-milk-based human-milk fortifier; MBM, maternal breast milk; PN, parenteral nutrition