Objective: The implications of strictly vegan diets during pregnancy remains insufficiently understood, we aimed to determine the impact of specific components of vegan diet on pregnancy outcomes, with particular emphasis on ne-onatal birthweight. Methods: This secondary analysis of a prospective observational study included women with singleton pregnancies who delivered at a single medical center and adhered to a consistent diet. Participants were classified as vegan or non-vegan and reported demo-graphic data and supplement use. During the third trimester, women completed a validated Food Frequency Questionnaire. Pregnancy outcomes were retrieved from a computerized database. SGA was defined as birthweight < 10th percentile. Results: Among 230 participants, 54 followed a vegan diet. Vegan diet had lower protein intake (60 vs. 82 g/day, p < 0.001). Higher protein percentage was associated with lower risk of SGA (RR=0.8, 95% CI: 0.673-0.956, p < 0.014). Amino acids profile differed significantly, with Leucine showing the strongest association with birthweight (p=0.003). vegan diets included higher carbohydrate (256 vs. 217 g), fiber (48 vs. 30 g), folate (627 vs. 416 µg), and iron (17 vs. 12 mg) intake, and lower fat (72 vs. 79 g), calcium (764 vs. 1053 mg), vitamin D (0.24 vs. 5.5 µg), vitamin B12 (1.5 vs. 4.6 µg), DHA (0 vs. 0.07 g), and choline (270 vs. 394 mg) (all p< 0.05). Conclusions: Vegan diet during pregnancy may increase the risk of SGA, possibly due to inadequate protein intake and composition, particularly leucine. Vitamin D, calcium, B12, and choline deficiencies are more common in vegan pregnant women.

Background/Objectives: Mother’s own milk (MOM) is widely recognized as the best source of nutrition for premature infants, with donor human milk (DHM) as the next recommended option. However, it remains controversial whether DHM confers the same benefits as MOM. We aimed to compare growth and clinical outcomes in very-low-birth-weight (VLBW) infants before and after the introduction of DHM in our Neonatal Intensive Care Unit (NICU). Methods: This is a retrospective cohort of VLBW and/or very-low-birth-weight infants born between January 2018 and June 2023. Infants were divided based on birth date into Epoch-1 (pre-DHM, N = 98) and Epoch-2 (post-DHM, N = 138). Feeding groups included exclusive MOM (N = 112), MOM + DHM (N = 71), and MOM + Formula (N = 39). Baseline characteristics were compared between groups. The primary outcome was weight gain; secondary outcomes included incidence of necrotizing enterocolitis (NEC), time to full enteral feeding, and length of hospitalization. Multivariable regression models were used to assess these outcomes while adjusting for relevant confounders. Results: Infants in Epoch-2 were born at a significantly higher gestational age (29.3 vs. 28.2 weeks, p < 0.001) and had a higher median birth weight (1350 g vs. 1080 g, p < 0.001) compared to Epoch-1. In this before-and-after cohort, the post-DHM implementation epoch was not independently associated with differences in growth or complication rates after adjustment. Time to reach full enteral feeding was significantly shorter in the post-DHM epoch (B = −0.255, p < 0.001). Conclusions: DHM had no independent effect on growth or complication rates but was associated with earlier achievement of full enteral feeding. Further studies are needed to evaluate its contribution to neonatal clinical outcomes.