Western Pacific Webinar: Nutritional management of moderate- and late-preterm babies: what happens when mothers’ own milk is the goal? by Tanith Alexander

Exclusive breastmilk is the desired enteral nutrition for babies born moderate- (MP) and late-preterm (LP); however, this goal is often difficult to achieve. The objective of the study was to explore the nutritional management of MP and LP babies commenced on intravenous (IV) fluids while waiting for mothers’ own milk (MOM).

The factors and timing associated with successful transition to MOM only were investigated in a prospective cohort of babies 32⁺⁰-35⁺⁶ weeks’ gestation enrolled in the DIAMOND trial. In this cohort, babies were randomised to a condition that specified the intention was to provide MOM as the only enteral feed whilst transitioning from IV fluids.

Of the 151 eligible babies included, 93 (63%) successfully transitioned from IV fluids onto MOM only. Factors associated with the commencement of alternative nutrition included gestational age, multiple birth, and ethnicity. Breastmilk feeding at discharge was associated with the successful provision of MOM, and ethnicity.

Despite an intention to provide only MOM during transition from IV fluids, significant numbers of MP and LP babies received infant formula to transition off IV fluids, and this differed by ethnicity.