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Cited by 14Infant Nutrition and HealthBreastfeeding Practices and InfluencesChild Nutrition and Water Access

The effect of milk type and fortification on the growth of low‐birthweight infants: An umbrella review of systematic reviews and meta‐analyses

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North, Krysten, Marx Delaney, Megan, Bose, Carl, Lee, Anne C. C., Vesel, Linda, Adair, Linda, Semrau, Katherine·2021·Maternal & Child Nutrition
DOI 10.1111/mcn.13176PMC PMC8189224
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Abstract

Approximately 15% of infants worldwide are born with low birthweight (<2500 g). These children are at risk for growth failure. The aim of this umbrella review is to assess the relationship between infant milk type, fortification and growth in low‐birthweight infants, with particular focus on low‐ and lower middle–income countries. We conducted a systematic review in PubMed, CINAHL, Embase and Web of Science comparing infant milk options and growth, grading the strength of evidence based on standard umbrella review criteria. Twenty‐six systematic reviews qualified for inclusion. They predominantly focused on infants with very low birthweight (<1500 g) in high‐income countries. We found the strongest evidence for (1) the addition of energy and protein fortification to human milk (donor or mother's milk) leading to increased weight gain (mean difference [MD] 1.81 g/kg/day; 95% confidence interval [CI] 1.23, 2.40), linear growth (MD 0.18 cm/week; 95% CI 0.10, 0.26) and head growth (MD 0.08 cm/week; 95% CI 0.04, 0.12) and (2) formula compared with donor human milk leading to increased weight gain (MD 2.51 g/kg/day; 95% CI 1.93, 3.08), linear growth (MD 1.21 mm/week; 95% CI 0.77, 1.65) and head growth (MD 0.85 mm/week; 95% CI 0.47, 1.23). We also found evidence of improved growth when protein is added to both human milk and formula. Fat supplementation did not seem to affect growth. More research is needed for infants with birthweight 1500–2500 g in low‐ and lower middle–income countries.

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  • Research on LBW is predominantly from high-income countries and focuses on very LBW (<1500g) or preterm infants.

    “Although 91% of LBW infants are born in low- and middle-income countries (LMIC) and the majority are moderately LBW (MLBW) (1500-<2500g) [4–6]; research is predominantly from high-income countries and focuses on very LBW (<1500g) or preterm infants [7].”

    From Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania (2023) · cites this paper as [7]

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Cited by

Sorted by citations

Authors
North, K., Marx Delaney, M., Bose, C., Lee, A. C. C., Vesel, L., Adair, L., & Semrau, K.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Ariadne Labs Brigham Women's Hospital and Harvard TH Chan School of Public Health Boston Massachusetts USA
  • Brigham and Women's Hospital (US)
Corresponding author
North, Krysten
ORCID
Venue
Maternal & Child Nutrition
Publisher
Wiley
Published
2021-03-17
Volume
17
Issue
3
Pages
e13176-e13176
ISSN
  • 1740-8695 (ISSN-L)
  • 1740-8709
DOI
10.1111/mcn.13176
PMC
PMC8189224
OpenAlex
W3138671587
Cited by
14
References
0
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 3
FWCI
0.37
Type
journal article
Language
en
Open access
Licence
Locations
  • Maternal and Child Nutrition (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Bill and Melinda Gates Foundation (OPP1192260)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
  • Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
Keywords
low birth weight infants, infant formula, breast milk, donor human milk, milk fortification, protein fortification, dietary fat supplementation, infant growth, weight gain, linear growth, head growth, very low birth weight, low- and middle-income countries
MeSH terms
Systematic Reviews as Topic, Birth Weight, Child, Humans, Infant, Infant Nutritional Physiological Phenomena, Infant, Newborn, Infant, Premature, Milk, Human, Infant, Very Low Birth Weight, Infant Formula

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