Effects of formula supplementation in breast-fed infants with failure to thrive

• Published in: Pediatrics international Vol. 51; no. 3; pp. 346 - 351
• Main Authors: Hren, Irena, Mis, Nataša Fidler, Brecelj, Jernej, Čampa, Andreja širca, Sedmak, Marjeta, Kržišnik, Ciril, Koletzko, Berthold
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01-06-2009; Blackwell Publishing Ltd
• Subjects: Babies; Baby foods; Body Weight; Breast Feeding; Breastfeeding & lactation; Childrens health; failure to thrive; Failure to Thrive - therapy; Fatty Acids - analysis; Female; Humans; Infant; infant formula; Infant Formula - chemistry; infant growth; infant nutrition; Infant, Newborn; Male; Prospective Studies
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/j.1442-200X.2008.02732.x

Background:  The aim of the present study was to assess whether formula supplementation of infants with failure to thrive can improve underweight without jeopardizing breast‐feeding.
Methods:  In a prospective intervention study 31 term exclusively breast‐fed infants were studied, who were admitted to hospital at an age of 28–99 days with failure to thrive (≤40% expected weight gain for age and/or bodyweight ≤10th percentile for age) without underlying disease. Infant formula was offered ad libitum after each breast‐feeding, while continued breast‐feeding was supported.
Results:  Energy intake per day increased from 352 ± 111 kJ/kg (mean ± SD) at study start to 587 ± 115 kJ/kg (P < 0.001, days 1–3 of supplementation) and 501 ± 99 kJ/kg (days 29–31; P < 0.001 vs study entry). Twenty‐five infants continued to be partially (n = 21) or fully (n = 4) breast‐fed. Human milk intake decreased from 476 ± 163 g/day (study days 1–3) to 349 ± 285 g/day (study days 29–31; P < 0.01). The contribution of breast milk to total milk intake decreased from 100% to 42 ± 35% (P < 0.001). Supplementation over 31 days led to increased weight (0.98 [0.70], standard deviation scores [SDS]), length (+0.40 [0.41] SDS) and head circumference (+0.59 [0.93] SDS).
Conclusions:  One month of formula supplementation successfully improved growth in 72% of infants with failure to thrive on human milk feeding. Breast‐feeding was maintained in 81% of infants.