Enteral Bioactive Factor Supplementation in Preterm Infants: A Systematic Review

• Published in: Nutrients Vol. 12; no. 10; p. 2916
• Main Authors: Mank, Elise, Naninck, Eva F G, Limpens, Jacqueline, van Toledo, Letty, van Goudoever, Johannes B, van den Akker, Chris H P
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24.09.2020; MDPI
• Subjects: Antiinfectives and antibacterials; Bias; Biological activity; Breast milk; Child Development - drug effects; Clinical trials; Cognition; Collaboration; Complications; Databases, Factual; Dietary Supplements; Enteral Nutrition; Fatty acids; Growth factors; Hormones; human milk; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Premature - growth & development; Infants; Insulin; Lactoferrin; Milk, Human; Neonates; Newborn babies; Nutrition; Postpartum period; Premature babies; premature neonate; Probiotics; Randomized Controlled Trials as Topic; Review; Reviews; Sepsis; Statistical analysis; Systematic review; Treatment Outcome; trophic factor; Vitamin A; Vitamin D; Vitamins; trophic factor; nutrition; human milk; premature neonate
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12102916

Feeding preterm infants with mother's own milk is associated with a reduction in postnatal complications and an improved neurocognitive outcome. Therefore, the bioactive factor composition of human milk has been used as a tool for the development of nutritional supplements with a potential prophylactic or therapeutic effect. The aim of this systematic review was to provide an overview on bioactive factors which have been studied as supplement to enteral nutrition in randomized controlled trials, and to provide an overview of ongoing trials. MEDLINE, EMBASE, CENTRAL, and clinical trial registers were searched. Studies on the antimicrobial protein lactoferrin were excluded as these were summarized very recently in three separate systematic reviews. Studies on vitamins D, K and iron were also excluded as they are already incorporated in most international guidelines. We identified 17 different bioactive factors, which were investigated in 26 studies. Despite the encouraging potential effects of several bioactive factors, more high-quality studies with a sufficient number of preterm infants are required before a certain factor may be implemented into clinical practice. Three large trials ( > 500) that investigate the effects of either enteral insulin or vitamin A are currently ongoing and could provide more definite answers on these specific supplements.