Publications of Virginie de HALLEUX
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See detailGrowth Benefits of Own Mother's Milk in Preterm Infants Fed Daily Individualized Fortified Human Milk.
de HALLEUX, Virginie ULiege; PIELTAIN, Catherine ULiege; SENTERRE, Thibault ULiege et al

in Nutrients (2019), 11(4), 772

The influence of types of human milk (HM)-raw own mother's milk (OMM), pasteurized OMM, and donor milk (DM)-was evaluated for growth in premature infants fed exclusively HM with controlled nutritional ... [more ▼]

The influence of types of human milk (HM)-raw own mother's milk (OMM), pasteurized OMM, and donor milk (DM)-was evaluated for growth in premature infants fed exclusively HM with controlled nutritional intakes using daily individualized HM fortification (IHMF). Growth and nutritional intakes were prospectively collected in preterm infants (<32 weeks) fed IHMF and compared in infants fed predominantly (>/=75%) OMM and DM. The influence of HM types (raw OMM, pasteurized OMM, and DM) on growth were also evaluated in the whole population. One-hundred and one preterm infants (birth weight 970 +/- 255 g, gestational age 27.8 +/- 1.9 weeks) were included. Energy (143 +/- 8 vs. 141 +/- 6 kcal/kg/day; p = 0.15) and protein intakes (4.17 +/- 0.15 vs. 4.15 +/- 0.14 g/kg/day; p = 0.51) were similar in both groups. Infants receiving predominantly OMM (n = 37), gained significantly more weight (19.8 +/- 2.0 vs. 18.2 +/- 2.2 g/kg/day; p = 0.002) and length (1.17 +/- 0.26 vs. 0.99 +/- 0.36 cm/week; p = 0.020) than those fed predominantly DM (n = 33). Stepwise multivariate analysis (n = 101) suggests that raw OMM was the major determinant of growth, contributing 22.7% of weight gain. Length gain was also related to OMM (raw + pasteurized) intakes, explaining 4.0% of length gain. In conclusion, at daily controlled similar protein and energy intakes, OMM had significant beneficial effects on weight and length versus DM in VLBW infants. This difference could be partially explained by the use of raw OMM. [less ▲]

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See detailSubjective assessment of perinatal adaptation and respiratory management in <29 weeks infants
RIGO, Vincent ULiege; BROUX, Isabelle ULiege; de HALLEUX, Virginie ULiege et al

Poster (2015, March 12)

Background A primary CPAP strategy is beneficial even in extremely preterm infants. Many still require intubation for stabilization. Half of those managed with primary CPAP will also require further ... [more ▼]

Background A primary CPAP strategy is beneficial even in extremely preterm infants. Many still require intubation for stabilization. Half of those managed with primary CPAP will also require further support: surfactant administration or mechanical ventilation, and have increased risks of death or neonatal morbidities, and will require longer respiratory support. Identifying them early, during the birth stabilization process, might lead to improvements in respiratory care. A subjective classification of perinatal adaptation as Good, Bad or Marginal has been suggested but not evaluated. Methods Single center retrospective study of <29 weeks premature infants admitted between 01/2013 and 07/2014. Neonatal database and discharge summaries provide neonatal care and outcome data. Good perinatal adaptation (GPA) is considered for infants with good respiratory drive, tone and low oxygen requirement in the delivery room. Infants with marginal (M) PA had intermittent respiratory drive, normocardia with ventilation, and decreasing FiO2. Bad (B) PA is considered with hypotonia, bradycardia, apnea and high FiO2. Results Among 58 infants (50 inborn), 16 had GPA, 19 MPA and 23 BPA. Risk factors for bad adaptation are (not significantly different-NS) male gender, lower GA , and absent/incomplete antenatal steroid exposure. Apgar score at 1 minute increases according to perinatal adaptation quality (B3,5; M5,5 and G7,4; p<0,01), with improvements at 5 minutes: 6,6; 7,0 (NS) and 8,3 (p(B)<0,01). Risk of intubation in the delivery room is associated with poorer adaptation: B83%, M58% and G12% (p<0,01). Primary CPAP success was not different according to groups (B 3/3; M66%; G56%). However, more infants with MPA received surfactant while on CPAP (LISA method): B 2/3; M:5/6 and G:4/7. This surfactant was given in the delivery room in 1, 4 and 2 infants respectively. For children intubated within day 3, the duration of the first invasive ventilation duration was 29 hours (B), 15h (M) and 9h (G), NS. Risk of early neonatal death decreases with improving perinatal adaptation: 26%, 16% (NS) and 0% (pB <0,05). Risk of BPD at 36 weeks is not different among groups (B 19%, M13%, G 12%), but combined risk of death or BPD at 36 weeks tends to decreases (B 43%, M 31%, G 12%, p=0,12). Conclusions Better perinatal adaptation improves chances of being initially managed with CPAP. CPAP success may be improved with less invasive surfactant therapy, especially in preterm infants with marginal adaptation. Perinatal adaptation assessment identifies mortality risk. [less ▲]

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See detailVariability in human milk composition: benefit of individualized fortification in very-low-birth-weight infants.
de HALLEUX, Virginie ULiege; Rigo, Jacques ULiege

in American Journal of Clinical Nutrition (2013), 98(2), 529-35

BACKGROUND: Preterm infants fed fortified human milk (HM) grow more slowly than those fed preterm formulas. These differences could be related to the variability in the macronutrient composition of ... [more ▼]

BACKGROUND: Preterm infants fed fortified human milk (HM) grow more slowly than those fed preterm formulas. These differences could be related to the variability in the macronutrient composition of expressed HM, resulting in inadequate nutrient intake in relation to the estimated needs of the preterm infants. OBJECTIVES: The aim of this article was to show the variability in HM composition from an infant's own mother's milk (OMM) or pooled HM from the milk bank. The second objective was to evaluate the advantages of individual fortification on nutritional intakes over standard fortification. DESIGN: The macronutrient composition of 428 OMM, 138 HM pools from single donors, 224 pools from multiple donors, and 14 pools from colostral milk was determined by using a mid-infrared analyzer. Individualized fortification was performed after analysis of the milk samples in 2 steps: adjustment of fat content up to 4 g/dL, followed by the addition of an HM fortifier to provide 4.3 g . kg(-1) . d(-1) according to the daily prescribed volume of feeding. Nutritional intakes resulting from the individualized fortification were compared with calculated intakes resulting from standard fortification (HM fortifier: 4 packets/dL). RESULTS: The variability in contents of fat, protein, and energy was high for all types of HM samples. Compared with standard fortification, individual fortification significantly reduced the variability in nutritional intakes, allowing the maintenance of protein intake and the protein:energy ratio in the range of the nutritional recommendations. CONCLUSIONS: The variability in expressed HM with respect to its protein and energy content is high. This variability persists after standard fortification, possibly resulting in under- or overnutrition. Because both over- and undernutrition confer risks in later development, individualized fortification optimizes protein and energy intake. [less ▲]

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