Growth and Biochemical Response of Preterm Infants Fed Human Milk or Modified Infant Formula

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Abstract
My colleagues and I compared the biochemical status and rates of growth of three groups of preterm infants: one group was fed milk obtained early from mothers of preterm infants; one group received milk produced during the mature stage of lactation by mothers of term infants; and one group received a whey-based infant formula. Sixty healthy preterm infants with birth weights of 1600 g or less were randomly assigned to one of the three feeding groups. The 20 infants in each group were followed until they reached a weight of 1800 g. The mean (±S.E.M.) number of days required to regain birth weight was similar for infants receiving the formula (10.3±0.8) and those receiving milk from mothers of preterm infants (11.4±0.8); both were significantly less than the number (18.8±1.7) for infants receiving milk from mothers of term infants (P<0.001). Subsequent rates of weight gain were greater for the groups receiving formula (27.0±0.8 g per day) and milk from mothers of preterm infants (23.7±1.1) than for the group receiving milk from mothers of term infants (15.8±0.8) (P<0.001). Similarly, the average increments in crown-to-heel length and in the head circumference were significantly greater for the groups given formula and milk from mothers of preterm infants (P<0.005 and P<0.001, respectively). These data indicate that feeding with either milk from mothers of preterm infants or a whey-based infant formula results in more appropriate growth in preterm infants than feeding with milk from mothers of term infants. (N Engl J Med. 1983; 308:237–41.)