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Milk feed osmolality and adverse events in newborn infants and animals: a systematic review

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Ellis, Zoë-Marie ; Tan, Hui Shan Grace ; Embleton, Nicolas D ; Sangild, Per Torp ; van Elburg, Ruurd M. / Milk feed osmolality and adverse events in newborn infants and animals : a systematic review. I: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2019 ; Bind 104, Nr. 3. s. F333-F340.

Bibtex

@article{fa522bbfede24d8b8275516acdb9e1af,
title = "Milk feed osmolality and adverse events in newborn infants and animals: a systematic review",
abstract = "BACKGROUND: High feed osmolality (or osmolarity) is often suggested to be linked with adverse gastrointestinal events in preterm infants.AIM: To systematically review the literature on milk feed osmolality and adverse gastrointestinal events in newborn and low birthweight infants and animals.METHODS: MEDLINE, Embase, CAB Abstracts, Current Contents, BIOSIS Previews and SciSearch were searched from inception to May 2018 to identify potentially relevant studies.INCLUSION CRITERIA: randomised controlled or observational studies of newborn and low birthweight infants or animals investigating the effects of milk-based feeds with different osmolalities. Only full-text, English-language papers were included.RESULTS: Ten human and six animal studies met the inclusion criteria. Of human studies, seven reported no differences in adverse events with varying feed osmolalities; one reported delayed gastric emptying with feed osmolarity of 539 mOsm/L compared with lower levels; one reported higher necrotising enterocolitis (NEC) incidence with feed osmolarity of 650 mOsm/L compared with 359 mOsm/L; one found higher NEC incidence with the lowest feed osmolality (326 mOsm/kg compared with 385 mOsm/kg). Of animal studies, two reported delayed gastric emptying with feed osmolarity >624 mOsm/L, one reported decreased survival due to dehydration with dietary osmolarities ≥765 mOsmol/L and none reported increased NEC incidence with differing feed osmolalities. No clear mechanisms were found, and diet composition differences limited the interpretations regarding the independent impact of osmolality.CONCLUSIONS: There is no consistent evidence that differences in feed osmolality in the range 300-500 mOsm/kg are associated with adverse gastrointestinal symptoms in neonates.",
keywords = "Animals, Animals, Newborn, Enterocolitis, Necrotizing/etiology, Gastric Emptying, Gastrointestinal Diseases/etiology, Humans, Infant Formula/adverse effects, Infant, Low Birth Weight, Infant, Newborn, Milk/adverse effects, Milk, Human/chemistry, Osmolar Concentration",
author = "Zo{\"e}-Marie Ellis and Tan, {Hui Shan Grace} and Embleton, {Nicolas D} and Sangild, {Per Torp} and {van Elburg}, {Ruurd M}",
note = "{\textcopyright} Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2019",
month = may,
doi = "10.1136/archdischild-2018-315946",
language = "English",
volume = "104",
pages = "F333--F340",
journal = "Archives of Disease in Childhood: Fetal and Neonatal Edition",
issn = "1359-2998",
publisher = "B M J Group",
number = "3",

}

RIS

TY - JOUR

T1 - Milk feed osmolality and adverse events in newborn infants and animals

T2 - a systematic review

AU - Ellis, Zoë-Marie

AU - Tan, Hui Shan Grace

AU - Embleton, Nicolas D

AU - Sangild, Per Torp

AU - van Elburg, Ruurd M

N1 - © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/5

Y1 - 2019/5

N2 - BACKGROUND: High feed osmolality (or osmolarity) is often suggested to be linked with adverse gastrointestinal events in preterm infants.AIM: To systematically review the literature on milk feed osmolality and adverse gastrointestinal events in newborn and low birthweight infants and animals.METHODS: MEDLINE, Embase, CAB Abstracts, Current Contents, BIOSIS Previews and SciSearch were searched from inception to May 2018 to identify potentially relevant studies.INCLUSION CRITERIA: randomised controlled or observational studies of newborn and low birthweight infants or animals investigating the effects of milk-based feeds with different osmolalities. Only full-text, English-language papers were included.RESULTS: Ten human and six animal studies met the inclusion criteria. Of human studies, seven reported no differences in adverse events with varying feed osmolalities; one reported delayed gastric emptying with feed osmolarity of 539 mOsm/L compared with lower levels; one reported higher necrotising enterocolitis (NEC) incidence with feed osmolarity of 650 mOsm/L compared with 359 mOsm/L; one found higher NEC incidence with the lowest feed osmolality (326 mOsm/kg compared with 385 mOsm/kg). Of animal studies, two reported delayed gastric emptying with feed osmolarity >624 mOsm/L, one reported decreased survival due to dehydration with dietary osmolarities ≥765 mOsmol/L and none reported increased NEC incidence with differing feed osmolalities. No clear mechanisms were found, and diet composition differences limited the interpretations regarding the independent impact of osmolality.CONCLUSIONS: There is no consistent evidence that differences in feed osmolality in the range 300-500 mOsm/kg are associated with adverse gastrointestinal symptoms in neonates.

AB - BACKGROUND: High feed osmolality (or osmolarity) is often suggested to be linked with adverse gastrointestinal events in preterm infants.AIM: To systematically review the literature on milk feed osmolality and adverse gastrointestinal events in newborn and low birthweight infants and animals.METHODS: MEDLINE, Embase, CAB Abstracts, Current Contents, BIOSIS Previews and SciSearch were searched from inception to May 2018 to identify potentially relevant studies.INCLUSION CRITERIA: randomised controlled or observational studies of newborn and low birthweight infants or animals investigating the effects of milk-based feeds with different osmolalities. Only full-text, English-language papers were included.RESULTS: Ten human and six animal studies met the inclusion criteria. Of human studies, seven reported no differences in adverse events with varying feed osmolalities; one reported delayed gastric emptying with feed osmolarity of 539 mOsm/L compared with lower levels; one reported higher necrotising enterocolitis (NEC) incidence with feed osmolarity of 650 mOsm/L compared with 359 mOsm/L; one found higher NEC incidence with the lowest feed osmolality (326 mOsm/kg compared with 385 mOsm/kg). Of animal studies, two reported delayed gastric emptying with feed osmolarity >624 mOsm/L, one reported decreased survival due to dehydration with dietary osmolarities ≥765 mOsmol/L and none reported increased NEC incidence with differing feed osmolalities. No clear mechanisms were found, and diet composition differences limited the interpretations regarding the independent impact of osmolality.CONCLUSIONS: There is no consistent evidence that differences in feed osmolality in the range 300-500 mOsm/kg are associated with adverse gastrointestinal symptoms in neonates.

KW - Animals

KW - Animals, Newborn

KW - Enterocolitis, Necrotizing/etiology

KW - Gastric Emptying

KW - Gastrointestinal Diseases/etiology

KW - Humans

KW - Infant Formula/adverse effects

KW - Infant, Low Birth Weight

KW - Infant, Newborn

KW - Milk/adverse effects

KW - Milk, Human/chemistry

KW - Osmolar Concentration

U2 - 10.1136/archdischild-2018-315946

DO - 10.1136/archdischild-2018-315946

M3 - Journal article

C2 - 30523072

VL - 104

SP - F333-F340

JO - Archives of Disease in Childhood: Fetal and Neonatal Edition

JF - Archives of Disease in Childhood: Fetal and Neonatal Edition

SN - 1359-2998

IS - 3

ER -

ID: 59422223