@article {VisuthranukulF242, author = {Chonnikant Visuthranukul and Steven A Abrams and Keli M Hawthorne and Joseph L Hagan and Amy B Hair}, title = {Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age}, volume = {104}, number = {3}, pages = {F242--F247}, year = {2019}, doi = {10.1136/archdischild-2017-314547}, publisher = {BMJ Publishing Group}, abstract = {Objective To compare postdischarge growth, adiposity and metabolic outcomes of appropriate for gestational age (AGA) versus small for gestational age (SGA) premature infants fed an exclusive human milk (HM)-based diet in the neonatal intensive care unit.Design Premature infants (birth weight <=1250 g) fed an exclusive HM-based diet were examined at 12{\textendash}15 months corrected gestational age (CGA) (visit 1) for anthropometrics, serum glucose and non-fasting insulin, and at 18{\textendash}22 months CGA (visit 2) for body composition by dual-energy X-ray absorptiometry.Results Of 51 children, 33 were AGA and 18 were SGA at birth. The SGA group had weight gain (g/day) equal to AGA group during the follow-up period. SGA had a significantly greater body mass index (BMI) z-score gain from visit 1 to visit 2 (0.25{\textpm}1.10 vs -0.21{\textpm}0.84, p=0.02) reflecting catch-up growth. There were no significant differences in total fat mass (FM) and trunk FM between groups. SGA had significantly lower insulin level (5.0{\textpm}3.7 vs 17.3{\textpm}15.1 {\textmu}U/mL, p=0.02) and homeostatic model of assessment-insulin resistance (1.1{\textpm}0.9 vs 4.3{\textpm}4.1, p=0.02). Although regional trunk FM correlated with insulin levels in SGA (r=0.893, p=0.04), they had lower insulin level compared with AGA and no difference in adiposity.Conclusions SGA premature infants who received an exclusive HM-based diet exhibited greater catch-up growth without increased adiposity or elevated insulin resistance compared with AGA at 2 years of age. An exclusive HM-based diet may improve long-term body composition and metabolic outcomes of premature infants with <=1250 g birth weight, specifically SGA.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/104/3/F242}, eprint = {https://fn.bmj.com/content/104/3/F242.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }