Dr. Amy Hair, a neonatologist and program director of the Neonatal Nutrition Program at Texas Children’s Hospital, was recently awarded a $350,000 research grant from the Gerber Foundation.
This generous grant will support the Targeted Fortification Project, a neonatal nutrition study led by Hair that will evaluate the short-term effects of a high versus standard protein diet on growth outcomes and body composition in the smallest preterm infants weighing between 500 to 1,000 grams.
“While an exclusive human milk diet is associated with improved outcomes in our highest risk neonates, it is important to evaluate the benefits of a high protein exclusive human milk diet and the possible positive changes in body composition, specifically lean mass, in these infants,” Hair said.
Using a randomized study design, infants in the control group will receive a standard protein diet that consists of mother’s own milk or donor human milk with donor human milk derived fortifier. Based on the amount of protein in the human milk, fortification of feeds will be adjusted to reach an average of 3.5 to 3.8 grams per kilogram per day of protein. Data will be recorded for milk analysis, nutrition and infant growth.
The intervention group will receive the same standard feeding regimen with the addition of extra human milk fortification to give a high protein diet. Based on the amount of protein in the human milk, fortification of feeds will be adjusted to reach an average of 4.2 to 4.5 grams per kilogram per day of protein.
Both diets will be continued until approximately 35 to 36 weeks postmenstrual age (an infant’s gestational age at birth plus postnatal age) and a bone mineral density and body composition scan will be performed.
“We hypothesize that infants who receive a high protein diet will have more lean mass and a 15 percent improvement in length velocity at 36 weeks postmenstrual age compared to infants who received only a standard protein diet,” Hair said.
Much of Hair’s research has been dedicated to improving the long-term outcomes of premature and critically ill infants in the neonatal intensive care unit (NICU). Her work in neonatal nutrition has led to significant changes in clinical practice in the NICU at Texas Children’s and other pediatric hospitals.
In her study published in Breastfeeding Medicine, Hair found that premature infants weighting less than 1,250 grams at birth improved their growth outcomes in the NICU after being fed an exclusive human milk-based diet. In a separate study published in the Journal of Pediatrics, Hair found that adding a human milk-based cream in the exclusive human milk diets of premature infants resulted in better growth outcomes in terms of weight and length than infants who received just the exclusive human milk diet.
As a result of Hair’s extensive research in neonatal nutrition, Texas Children’s Newborn Center implemented an exclusive human milk feeding protocol in 2009, which has led to a 77 percent decrease in the rate of necrotizing enterocolitis, a devastating intestinal disease that affects premature infants.
“I am grateful to the Gerber Foundation for providing Texas Children’s with this research grant,” said Hair, who is also an assistant professor of pediatrics at Baylor College of Medicine. “This will help advance neonatal nutrition research to continue to improve the outcomes of premature and critically ill infants.”