701 - Serum Ferritin and Hemoglobin Levels in Very Preterm Infants fed Donor Breast Milk

Publication Number: 701.6956

Anoop S. Pulickal, AdventHealth for Children, Winter Springs, FL, United States; Rajan Wadhawan, AdventHealth, Winter Park, FL, United States; William NMN. Oh, Women and Infants' Hospital, Barrington, RI, United States

Background: In preterm and low birth weight (LBW) infants, moderate-certainty evidence suggests that feeding with commercial formula compared to donor breast milk (DBM) is associated with a higher risk of developing necrotizing enterocolitis. Therefore, pasteurized DBM is increasingly utilized for preterm infants in whom maternal breast milk is unavailable or contraindicated. However, in-vitro evidence exists for significantly lower iron content in DBM after pasteurization. There exists no data on the in-vivo serum ferritin and hemoglobin profile of preterm infants who receive DBM to determine if iron deficiency might occur and whether additional iron supplementation might be indicated in this group.

Objective: To compare the serum ferritin level and hemoglobin levels in very preterm infants receiving DBM to those receiving MBM.

Design/Methods: Prospective, observational, cohort study of very preterm infants (29 to 32 weeks) at Adventhealth for Children, receiving either MBM or DBM. Serum ferritin and hemoglobin levels were obtained at 12 to14 days of age and at 2 weeks post-initiation of iron supplementation. Demographic and clinical data were collected from a chart review. SPSS version 2.0 was utilized for statistical analyses.

Results: 34 infants were consented and enrolled with an equal number in the MBM and DBM group. Interim analyses demonstrated no difference in the demographic characteristics, cord clamping data or iron supplementation regimens. Median levels of ferritin at 12 to 14 days were 178 and 238.1 ng/ml (p=0.1451) with hemoglobin levels at 12.3 and 13.6 mg/dL (p=0.3473) in the DBM and MBM cohorts respectively. Likewise, at two weeks post-iron supplementation, ferritin levels in DBM and MBM groups were 149.5 and 146ng/ml respectively (p=0.7266). Contemporaneous hemoglobin levels were 10 and 10.3 mg/dL in the DBM and MBM cohorts respectively.

Conclusion(s): Interim analysis shows that in very preterm infants, the use of pasteurized DBM is not associated with a decrease in the ferritin level or hemoglobin levels as compared to infants fed MBM.