Introduction Very preterm infants (VPIs) surgically treated for necrotizing enterocolitis (NEC) are at risk of growth retardation. The aim of this study was to demonstrate and compare growth during the first 6 years of life in VPIs with stoma after NEC surgery with VPIs without NEC surgery. Materials and Methods We included all VPIs surgically treated due to NEC at the Odense University Hospital from August 1, 2004, to July 31, 2008. Outcome on growth was compared with a group of VPIs without NEC. The VPIs with NEC were identified searching the local database using the International Classification of Diseases, 10th Revision diagnosis of NEC (DP77.9). Data on growth were collected from medical files and if not present, the parents reported the data. Results Nineteen VPIs, surgically treated due to NEC, survived to 6 years of age. Median gestational age was 28^3/7 weeks (24^5/7–31^3/7). Median age at NEC surgery and stoma formation was 2.3 weeks (0.1–6.3) and median age at stoma closure was 2.5 months corrected age (CA) (postmenstrual age 36 weeks to CA 6.7 months). Compared with the non-NEC group, VPIs with NEC and stoma demonstrated poor growth, especially in head circumference (HC) with no increase in growth velocity before the time of stoma closure between 2.5- and 3-month CAs. Conclusion Our findings demonstrate poor growth in VPIs after NEC surgery and improved HC growth after stoma closure. Received: 27 April 2020 Accepted: 27 August 2020 Publication Date: 20 October 2020 (online) © 2020. Thieme. All rights reserved. Georg Thieme Verlag KG Stuttgart · New York

Breastfed infants have different growth patterns to formula-fed infants and are less likely to develop obesity later in life. Nesfatin-1 is an anorexigenic adipokine that was discovered in human milk more than a decade ago, and its role in infant appetite regulation is not clear. Our aim was to describe nesfatin-1 levels in human milk collected 3–4 months postpartum, associations with infant anthropometry, and factors (maternal pre-pregnancy body mass index (mBMI), high weight gain during pregnancy, milk fat, and energy content) possibly influencing nesfatin-1 levels. We hypothesized that nesfatin-1 levels in mother’s milk would differ for infants that were large (high weight-for-age Z-score (WAZ)) or small (low WAZ) at the time of milk sample collection. We used enzyme-linked immunosorbent assay to detect the nesfatin-1 concentration in milk samples from mothers to high WAZ (n = 50) and low WAZ (n = 50) infants. We investigated associations between nesfatin-1 levels and infant anthropometry at 3–4 months of age and growth since birth, using linear regression adjusted for mBMI, birth weight, infant sex, and exclusivity of breastfeeding. We found no difference in nesfatin-1 levels between the two groups and no association with infant anthropometry, even after adjusting for potential confounders. However, high nesfatin-1 levels were correlated with low mBMI. Future research should investigate serum nesfatin-1 level in both mothers, infants and associations with growth in breastfed children.

Background/Objectives: Human milk (HM) meets the nutritional needs of term-born infants. However, it remains unclear whether HM macronutrient concentrations and intakes differ by infant sex. We investigated sex- and country-specific differences in HM macronutrient and energy concentrations among exclusively breastfeeding Danish and Australian mothers, and sex-specific differences in 24 h HM intake and intakes of HM macronutrients, energy, and energy ratio in Australian infants. Methods: In this cross-sectional, multicenter study, 77 Danish and 84 Australian mothers donated HM samples between 2.5 and 5.5 months postpartum. Mid-infrared spectroscopy analyzed macronutrient concentration in the Danish samples. The creamatocrit method analyzed fat and biochemical assays analyzed lactose and protein in the Australian samples. Milk intake was measured using the test-weighing method. We used linear mixed-effect models to investigate sex- and country-specific differences. Results: There were no sex-specific differences in macronutrient and energy concentrations within either Danish or Australian cohorts. In all 161 HM samples, we found no sex-specific differences in lactose and protein concentrations. The 24 h median protein intake in Australian infants was 7.82 g in males and 7.26 g in females, (p = 0.274). The protein:energy ratio intake was 0.06 and 0.07 in male and females, respectively (p = 0.154). We also found no significant sex-specific differences in 24 h HM intake or intakes of fat, lactose, or energy. Conclusions: These findings suggest that males and females have similar macronutrient requirements during infancy. However, this needs to be confirmed in larger studies measuring 24 h milk intake.