Growth and micronutrient status parameters of Nigerian preterm infants consuming preterm formula or breastmilk

BACKGROUND

Moderate-to-late preterm infants (32-34 weeks GA) have increased risk of neonatal morbidities compared to term infants, however dedicated nutritional guidelines are lacking.

METHODS

Moderate-to-late preterm infants received a preterm formula (n = 17) or breastmilk (n = 24) from age 2-10 weeks in a non-randomized, open-label observational study. Anthropometric measurements were assessed bi-weekly. Blood concentrations of hemoglobin, ferritin, serum retinol, and 25-hydroxy-vitamin D (25OHD) were analyzed at age 2 and 10 weeks.

RESULT

Average growth per day was 14.7 g/kg BW/day in formula-fed and 12.8 g/kg BW/day in breastmilk-fed infants but not different from each other. Length and head circumference in both groups were in line with the median reference values of the Fenton growth chart. At 10 weeks of age, hemoglobin tended to be higher in the formula-fed group (10.2 g/dL vs. 9.6 g/dL, p = 0.053). 25OHD increased in formula- and breastmilk-fed infants from 73.8 to 180.9 nmol/L and from 70.7 to 97.6 nmol/L, respectively. Serum retinol only increased in the formula-fed group (0.63 to 1.02 µmol/L, p < 0.001).

CONCLUSION

Breastfeeding resulted in adequate growth in moderate-late preterm infants but was limiting in some micronutrients. The preterm formula provided adequate micronutrients, but weight gain velocity was higher than the Fenton reference value.

IMPACT STATEMENT

Unfortified breastmilk resulted in adequate growth in weight, length and head circumference in Nigerian moderate to late preterm infants during an study period of 8 weeks, but status of vitamin D, vitamin A and iron needs to be monitored. The high-energy formula, developed for very preterm infants, resulted in higher growth in body weight in moderate to late preterm infants than the median of the Fenton preterm growth chart. This study supports the necessity of dedicated nutritional guidelines, and regular monitoring of growth and nutritional status of moderate to late preterm infants.

Masturbation Injury Following Intravaginal Introduction of a Candlestick: A Case Report

Masturbation, a common sexual behaviour, may result in life-threatening injuries. Here the authors present a case of 40 years old female patient, P2L2 who presented to the Gynaecological Emergency unit, on account of a three-hour history of bleeding per vagina following candlestick masturbation which resulted in a 4 cm right lateral vaginal fornix laceration and accompanying hypovolemic shock. She was separated from her husband for a period of 2 years. She underwent examination under anaesthesia and repair of vaginal laceration. Postoperatively, she had one unit of blood transfused and was discharged for home on haematinics, broad spectrum antibiotics and analgesics. Counselling on marital stress and sexual distress was provided, while encouraging the use of adult sex toys in favour of improvised ones when necessary.