human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Preterm children are at high risk of poor growth performance . In 2 r and omized trials , preterm infants fed preterm formula grew better in the neonatal period than those fed banked donor breast milk or st and ard term formula . OBJECTIVE Our objective was to test the hypothesis that for preterm infants , the neonatal period is a critical one for programming growth performance and that early diet influences long-term growth . DESIGN A total of 926 preterm infants were recruited into 2 parallel , r and omized trials of neonatal diet . In trial 1 , infants were fed either banked donor breast milk or preterm formula whereas in trial 2 , infants were fed either st and ard term formula or preterm formula . Within each trial , the allocated milk was the sole diet for some infants ( study A ) , whereas for others it was a supplement to maternal breast milk , given when not enough expressed breast milk was available ( study B ) . We followed up 781 of 833 survivors ( 94 % ) to age 7.5 - 8 y. Trained assessors obtained anthropometric measurements according to a st and ard protocol . RESULTS Despite significantly better neonatal growth performance in infants fed preterm formula ( compared with either banked donor breast milk or st and ard formula ) , early diet had no influence on weight , height , head circumference , or skinfold thicknesses at 9 or 18 mo postterm or at age 7.5 - 8 y. CONCLUSIONS These findings suggest that the preterm period is not a critical window for nutritional programming of growth , which contrasts with evidence from these trials showing that early diet influences later neurodevelopment Poor weight gain observed in preterm infants who were fed expressed breast milk compared with those fed a cows ' milk formular  prompted a detailed study of early postnatal growth in preterm infants fed these two milks . 68 infants were divided into two categories by gestational age at birth ( i ) 28 - 32 weeks ( n=28 ) , ( ii ) 33 - 36 weeks ( n=40 ) . They were r and omly allocated to a feed of expressed breast milk or a milk formula ( Ostermilk 1 ) . Rates of weight gain , linear growth , and head circumference growth were evaluated over two periods : birth-1 month , 1 - 2 months . The younger group who were fed breast milk showed slower overall growth rates over the first month than those fed formula . In the second month , and for the older infants over both of the 2-monthly periods , growth rates were similar in the two feeding regimens . It is concluded that expressed breast milk is inadequate for the growth of very immature preterm infants during early postnatal life In r and omised study of 186 preterm infants those fed on maternal or banked breast milk  had a significantly higher peak bilirubin concentration and a more prolonged jaundice than infants fed an artificial preterm formula and were over four times more likely to achieve plasma bilirubin values above 200 mumol/l ( 11.7 mg/100 ml ) . This dietary effect was seen even in a high risk subgroup of sick ventilated infants below 1500 g who were receiving restricted enteral intakes . We suggest that breast milk jaundice in preterm infants may increase clinical intervention . Our findings are discussed in the light of epidemiological data suggesting an association between moderate hyperbilirubinaemia ( greater than 170 mumol/l ) and neurodevelopmental outcome Abstract Objectives : To test whether nutrition early in20infants ' development programmes later blood pressure and whether the reported relation between low birth weight and later high blood pressure is due to poor nutrition or growth before full term . Design : Prospect i ve r and omisation of preterm infants to early diets differing greatly in nutrient content in four parallel multicentre trials , with blinded follow up 7.5 - 8 years later . Setting : Neonatal units at Cambridge , Ipswich , King 's Lynn , Norwich , and Sheffield . Subjects : 758 children weighing under 1850 g at birth . Main outcome measure : Blood pressure at age of 7.5 - 8 years . Results : There were major differences in nutrient intake from r and omised diets ( preterm formula v st and ard formula and preterm formula v donor breast milk ; in each case with or without mother 's milk ) , but follow up showed no differences in later blood pressure . Individual subjects showed large variation in protein and energy intakes and in growth performance , including degrees of growth failure seldom seen in utero , but these factors were also unrelated to later blood pressure . Conclusion : Extremes of nutritional intake and growth performance in preterm infants do not programme later blood pressure at 7.5 - 8 years of age . These findings do not support the hypothesis that high blood pressure has early nutritional origins . We suggest that the long term rise in blood pressure reported in individuals who had low birthweight ( at full term ) is not , as previously speculated , due to poor fetal nutrition or growth as such A large multicentre study on the short and long term clinical and developmental outcome of infants r and omised to different diets is being undertaken . This report represents an interim analysis of the early postnatal growth performance of an unselected population of 194 preterm infants ( gestation , mean ( SD ) 31 . 0 ( 2 . 9 ) weeks ; birthweight , mean ( SD ) 1364 ( 294 ) g ) , both ill and well , examined in two ( of four ) parallel trials . One trial compared banked breast milk with a new preterm formula ( primary trial ) ; the other compared these diets as supplements to maternal milk ( supplement trial ) . A major dietary effect on the number of days taken to regain birthweight and subsequent gains in weight , length , and head circumference was observed in the primary trial . Infants fed banked breast milk  and weighing less than 1200 g at birth took a calculated additional three weeks to reach 2000 g compared with those fed on the preterm formula . A significant influence of diet on body proportions was seen in the relation between body weight , head circumference , and length . Similar though smaller differences in growth patterns were seen in the supplement trial . By the time they reach 2000 g , infants of birthweights 1200 to 1849 g fed on banked breast milk and infants below 1200 g fed on either banked breast milk or maternal milk supplemented ( as necessary ) with banked breast milk , fulfilled stringent criteria for failure to thrive ( weight less than 2 SD below the mean for age ) . Only infants fed the preterm formula as their sole diet had maintained their birth centile by discharge from hospital . The misleading nature of comparisons between extrauterine and intrauterine steady state weight gains is emphasised Few data from r and omised prospect i ve studies address whether early diet influences later neurodevelopment in man . As part of a larger multicentre trial , 502 low birthweight infants were assigned r and omly , for a median of 30 days , to receive a preterm formula or unfortified donor breast milk as sole diets or as supplements to their mothers ' expressed milk . Surviving infants were assessed at nine months after their expected date of delivery without knowledge of their feeding regimen . The mean developmental quotient was 0.25 st and ard deviations lower in those fed donor breast milk rather than preterm formula . In infants fed their mother 's expressed milk , however , the disadvantage of receiving banked milk compared with preterm formula as a supplement , was greater when the supplement was over half the total intake , and approached five points , representing 0.5 st and ard deviations for developmental quotient . Infants fed donor breast milk were at particular disadvantage following fetal growth retardation , with developmental quotients 5.3 points lower . We suggest that the diet used for low birthweight babies over a brief , but perhaps critical , postnatal period has developmental consequences that persist into infancy ; infants who are small for gestational age are especially vulnerable to suboptimal postnatal nutrition My colleagues and I compared the biochemical status and rates of growth of three groups of preterm infants : one group was fed  milk obtained early from mothers of preterm infants ;  one group received  milk produced during the mature stage of lactation by mothers of term infants ; and one group received a whey-based infant formula . Sixty healthy preterm infants with birth weights of 1600 g or less were r and omly assigned to one of the three feedings groups . The 20 infants in each group were followed until they reached a weight of 1800 g. The mean ( + /- S.E.M. ) number of days required to regain birth weight was similar for infants receiving the formula ( 10.3 + /- 0.8 ) and those receiving milk from mothers of preterm infants ( 11.4 + /- 0.8 ) ; both were significantly less than the number ( 18.8 + /- 1.7 ) for infants receiving milk from mothers of term infants ( P less than 0.001 ) . Subsequent rates of weight gain were greater for the groups receiving formula ( 27.0 + /- 0.8 g per day ) and milk from mothers of preterm infants ( 23.7 + /- 1.1 ) than for the group receiving milk from mothers of term infants ( 15.8 + /- 0.8 ) ( P less than 0.001 ) . Similarly , the average increments in crown-to-heel length and in the head circumference were significantly greater for the groups given formula and milk from mothers of preterm infants ( P less than 0.005 and P less than 0.001 , respectively ) . These data indicate that feeding with either milk from mothers of preterm infants or a whey-based infant formula results in more appropriate growth in preterm infants than feeding with milk from mothers of term infants Objective . Compared with preterm formula ( PF ) , mother 's milk ( MM ) is associated with lower rates of late-onset sepsis ( LOS ) and necrotizing enterocolitis ( NEC ) among premature infants . Because not all mothers of premature infants produce sufficient milk to supply their infants throughout hospitalization , we reasoned that pasteurized donor human milk ( DM ) would be a suitable alternative . Methods . Extremely premature infants ( < 30 weeks of gestation ) whose mothers intended to breastfeed were assigned r and omly to receive either pasteurized DM or PF if the supply of their own MM became insufficient during the study ( birth to 90 days of age or hospital discharge ) . Infection-related events ( LOS , NEC , meningitis , presumed sepsis , or urinary tract infection ) that occurred after the attainment of a milk intake of 50 mL/kg , dietary intake , growth , skin-to-skin contact , and duration of hospital stay were compared . The primary analysis compared groups DM and PF on an intent-to-treat basis . If no differences were noted , then these groups were combined and compared with the reference group , group MM . If differences were noted , then the subsequent analyses compared each group with group MM . Results . Of 243 infants , 70 ( 29 % ) received only MM ; group DM included 81 infants and group PF included 92 infants . Because of poor weight gain , 17 infants ( 21 % ) , all in group DM , were switched to PF . There were no differences in birth weight , gestational age , multiple births , and age at attainment of feeding of 50 mL/kg among groups . There were no differences between group DM and group PF in LOS and /or NEC , other infection-related events , hospital stay , or number of deaths . Group DM received a greater intake of milk and more nutritional supplements but had a slower rate of weight gain , compared with group PF . Compared with groups DM and PF , group MM had fewer episodes of LOS and /or NEC and total infection-related events and a shorter duration of hospital stay . Group MM also had fewer Gram-negative organisms isolated from blood cultures than did the other groups . Conclusions . In this r and omized , blinded trial of feeding of extremely premature infants , we found that , as a substitute for MM , DM offered little observed short-term advantage over PF for feeding extremely premature infants . Advantages to an exclusive diet of MM were observed in terms of fewer infection-related events and shorter hospital stays In a prospect i ve multicentre study on 926 preterm infants formally assigned to their early diet , necrotising enterocolitis developed in 51 ( 5.5 % ) .  Mortality was 26 % in stringently confirmed cases . In exclusively  formula-fed  babies confirmed disease was 6 - 10 times more common than in those fed breast milk alone and 3 times more common than in those who received formula plus breast milk . Pasteurised donor milk seemed to be as protective as raw maternal milk . Among babies born at more than 30 weeks ' gestation confirmed necrotising enterocolitis was rare in those whose diet included breast milk ; it was 20 times more common in those fed formula only . Other risk factors included very low  gestational age , respiratory disease , umbilical artery catheterisation , and polycythaemia . In formula-fed but not breast-milk-fed infants , delayed enteral feeding was associated with a lower frequency of necrotising enterocolitis . With the fall in the use of breast milk in British neonatal units , exclusive formula feeding could account for an estimated 500 extra cases of necrotising enterocolitis each year . About 100 of these infants would die Whether breast milk influences later neurodevelopment  has been explored in non-r and omised studies , potentially confounded by social and demographic differences between feed groups . Here in a strictly r and omised prospect i ve multicentre trial , Bayley psychomotor and mental development indices ( PDI and MDI ) were assessed at 18 months postterm in survivors of 502 preterm infants assigned to receive , during their early weeks , mature donor breast milk or a preterm formula .  These diets were compared as sole enteral feeds or as supplements to the mother 's expressed breast milk . No differences in outcome at 18 months were seen between the two diet groups despite the low nutrient content of donor milk in 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Preterm children are at high risk of poor growth performance . In 2 r and omized trials , preterm infants fed preterm formula grew better in the neonatal period than those fed banked donor breast milk or st and ard term formula . OBJECTIVE Our objective was to test the hypothesis that for preterm infants , the neonatal period is a critical one for programming growth performance and that early diet influences long-term growth . DESIGN A total of 926 preterm infants were recruited into 2 parallel , r and omized trials of neonatal diet . In trial 1 , infants were fed either banked donor breast milk or preterm formula whereas in trial 2 , infants were fed either st and ard term formula or preterm formula . Within each trial , the allocated milk was the sole diet for some infants ( study A ) , whereas for others it was a supplement to maternal breast milk , given when not enough expressed breast milk was available ( study B ) . We followed up 781 of 833 survivors ( 94 % ) to age 7.5 - 8 y. Trained assessors obtained anthropometric measurements according to a st and ard protocol . RESULTS Despite significantly better neonatal growth performance in infants fed preterm formula ( compared with either banked donor breast milk or st and ard formula ) , early diet had no influence on weight , height , head circumference , or skinfold thicknesses at 9 or 18 mo postterm or at age 7.5 - 8 y. CONCLUSIONS These findings suggest that the preterm period is not a critical window for nutritional programming of growth , which contrasts with evidence from these trials showing that early diet influences later neurodevelopment Poor weight gain observed in preterm infants who were fed expressed breast milk compared with those fed a cows ' milk formular  prompted a detailed study of early postnatal growth in preterm infants fed these two milks . 68 infants were divided into two categories by gestational age at birth ( i ) 28 - 32 weeks ( n=28 ) , ( ii ) 33 - 36 weeks ( n=40 ) . They were r and omly allocated to a feed of expressed breast milk or a milk formula ( Ostermilk 1 ) . Rates of weight gain , linear growth , and head circumference growth were evaluated over two periods : birth-1 month , 1 - 2 months . The younger group who were fed breast milk showed slower overall growth rates over the first month than those fed formula . In the second month , and for the older infants over both of the 2-monthly periods , growth rates were similar in the two feeding regimens . It is concluded that expressed breast milk is inadequate for the growth of very immature preterm infants during early postnatal life In r and omised study of 186 preterm infants those fed on maternal or banked breast milk  had a significantly higher peak bilirubin concentration and a more prolonged jaundice than infants fed an artificial preterm formula and were over four times more likely to achieve plasma bilirubin values above 200 mumol/l ( 11.7 mg/100 ml ) . This dietary effect was seen even in a high risk subgroup of sick ventilated infants below 1500 g who were receiving restricted enteral intakes . We suggest that breast milk jaundice in preterm infants may increase clinical intervention . Our findings are discussed in the light of epidemiological data suggesting an association between moderate hyperbilirubinaemia ( greater than 170 mumol/l ) and neurodevelopmental outcome Abstract Objectives : To test whether nutrition early in20infants ' development programmes later blood pressure and whether the reported relation between low birth weight and later high blood pressure is due to poor nutrition or growth before full term . Design : Prospect i ve r and omisation of preterm infants to early diets differing greatly in nutrient content in four parallel multicentre trials , with blinded follow up 7.5 - 8 years later . Setting : Neonatal units at Cambridge , Ipswich , King 's Lynn , Norwich , and Sheffield . Subjects : 758 children weighing under 1850 g at birth . Main outcome measure : Blood pressure at age of 7.5 - 8 years . Results : There were major differences in nutrient intake from r and omised diets ( preterm formula v st and ard formula and preterm formula v donor breast milk ; in each case with or without mother 's milk ) , but follow up showed no differences in later blood pressure . Individual subjects showed large variation in protein and energy intakes and in growth performance , including degrees of growth failure seldom seen in utero , but these factors were also unrelated to later blood pressure . Conclusion : Extremes of nutritional intake and growth performance in preterm infants do not programme later blood pressure at 7.5 - 8 years of age . These findings do not support the hypothesis that high blood pressure has early nutritional origins . We suggest that the long term rise in blood pressure reported in individuals who had low birthweight ( at full term ) is not , as previously speculated , due to poor fetal nutrition or growth as such A large multicentre study on the short and long term clinical and developmental outcome of infants r and omised to different diets is being undertaken . This report represents an interim analysis of the early postnatal growth performance of an unselected population of 194 preterm infants ( gestation , mean ( SD ) 31 . 0 ( 2 . 9 ) weeks ; birthweight , mean ( SD ) 1364 ( 294 ) g ) , both ill and well , examined in two ( of four ) parallel trials . One trial compared banked breast milk with a new preterm formula ( primary trial ) ; the other compared these diets as supplements to maternal milk ( supplement trial ) . A major dietary effect on the number of days taken to regain birthweight and subsequent gains in weight , length , and head circumference was observed in the primary trial . Infants fed banked breast milk  and weighing less than 1200 g at birth took a calculated additional three weeks to reach 2000 g compared with those fed on the preterm formula . A significant influence of diet on body proportions was seen in the relation between body weight , head circumference , and length . Similar though smaller differences in growth patterns were seen in the supplement trial . By the time they reach 2000 g , infants of birthweights 1200 to 1849 g fed on banked breast milk and infants below 1200 g fed on either banked breast milk or maternal milk supplemented ( as necessary ) with banked breast milk , fulfilled stringent criteria for failure to thrive ( weight less than 2 SD below the mean for age ) . Only infants fed the preterm formula as their sole diet had maintained their birth centile by discharge from hospital . The misleading nature of comparisons between extrauterine and intrauterine steady state weight gains is emphasised Few data from r and omised prospect i ve studies address whether early diet influences later neurodevelopment in man . As part of a larger multicentre trial , 502 low birthweight infants were assigned r and omly , for a median of 30 days , to receive a preterm formula or unfortified donor breast milk as sole diets or as supplements to their mothers ' expressed milk . Surviving infants were assessed at nine months after their expected date of delivery without knowledge of their feeding regimen . The mean developmental quotient was 0.25 st and ard deviations lower in those fed donor breast milk rather than preterm formula . In infants fed their mother 's expressed milk , however , the disadvantage of receiving banked milk compared with preterm formula as a supplement , was greater when the supplement was over half the total intake , and approached five points , representing 0.5 st and ard deviations for developmental quotient . Infants fed donor breast milk were at particular disadvantage following fetal growth retardation , with developmental quotients 5.3 points lower . We suggest that the diet used for low birthweight babies over a brief , but perhaps critical , postnatal period has developmental consequences that persist into infancy ; infants who are small for gestational age are especially vulnerable to suboptimal postnatal nutrition My colleagues and I compared the biochemical status and rates of growth of three groups of preterm infants : one group was fed  milk obtained early from mothers of preterm infants ;  one group received  milk produced during the mature stage of lactation by mothers of term infants ; and one group received a whey-based infant formula . Sixty healthy preterm infants with birth weights of 1600 g or less were r and omly assigned to one of the three feedings groups . The 20 infants in each group were followed until they reached a weight of 1800 g. The mean ( + /- S.E.M. ) number of days required to regain birth weight was similar for infants receiving the formula ( 10.3 + /- 0.8 ) and those receiving milk from mothers of preterm infants ( 11.4 + /- 0.8 ) ; both were significantly less than the number ( 18.8 + /- 1.7 ) for infants receiving milk from mothers of term infants ( P less than 0.001 ) . Subsequent rates of weight gain were greater for the groups receiving formula ( 27.0 + /- 0.8 g per day ) and milk from mothers of preterm infants ( 23.7 + /- 1.1 ) than for the group receiving milk from mothers of term infants ( 15.8 + /- 0.8 ) ( P less than 0.001 ) . Similarly , the average increments in crown-to-heel length and in the head circumference were significantly greater for the groups given formula and milk from mothers of preterm infants ( P less than 0.005 and P less than 0.001 , respectively ) . These data indicate that feeding with either milk from mothers of preterm infants or a whey-based infant formula results in more appropriate growth in preterm infants than feeding with milk from mothers of term infants Objective . Compared with preterm formula ( PF ) , mother 's milk ( MM ) is associated with lower rates of late-onset sepsis ( LOS ) and necrotizing enterocolitis ( NEC ) among premature infants . Because not all mothers of premature infants produce sufficient milk to supply their infants throughout hospitalization , we reasoned that pasteurized donor human milk ( DM ) would be a suitable alternative . Methods . Extremely premature infants ( < 30 weeks of gestation ) whose mothers intended to breastfeed were assigned r and omly to receive either pasteurized DM or PF if the supply of their own MM became insufficient during the study ( birth to 90 days of age or hospital discharge ) . Infection-related events ( LOS , NEC , meningitis , presumed sepsis , or urinary tract infection ) that occurred after the attainment of a milk intake of 50 mL/kg , dietary intake , growth , skin-to-skin contact , and duration of hospital stay were compared . The primary analysis compared groups DM and PF on an intent-to-treat basis . If no differences were noted , then these groups were combined and compared with the reference group , group MM . If differences were noted , then the subsequent analyses compared each group with group MM . Results . Of 243 infants , 70 ( 29 % ) received only MM ; group DM included 81 infants and group PF included 92 infants . Because of poor weight gain , 17 infants ( 21 % ) , all in group DM , were switched to PF . There were no differences in birth weight , gestational age , multiple births , and age at attainment of feeding of 50 mL/kg among groups . There were no differences between group DM and group PF in LOS and /or NEC , other infection-related events , hospital stay , or number of deaths . Group DM received a greater intake of milk and more nutritional supplements but had a slower rate of weight gain , compared with group PF . Compared with groups DM and PF , group MM had fewer episodes of LOS and /or NEC and total infection-related events and a shorter duration of hospital stay . Group MM also had fewer Gram-negative organisms isolated from blood cultures than did the other groups . Conclusions . In this r and omized , blinded trial of feeding of extremely premature infants , we found that , as a substitute for MM , DM offered little observed short-term advantage over PF for feeding extremely premature infants . Advantages to an exclusive diet of MM were observed in terms of fewer infection-related events and shorter hospital stays In a prospect i ve multicentre study on 926 preterm infants formally assigned to their early diet , necrotising enterocolitis developed in 51 ( 5.5 % ) .  Mortality was 26 % in stringently confirmed cases . In exclusively  formula-fed  babies confirmed disease was 6 - 10 times more common than in those fed breast milk alone and 3 times more common than in those who received formula plus breast milk . Pasteurised donor milk seemed to be as protective as raw maternal milk . Among babies born at more than 30 weeks ' gestation confirmed necrotising enterocolitis was rare in those whose diet included breast milk ; it was 20 times more common in those fed formula only . Other risk factors included very low  gestational age , respiratory disease , umbilical artery catheterisation , and polycythaemia . In formula-fed but not breast-milk-fed infants , delayed enteral feeding was associated with a lower frequency of necrotising enterocolitis . With the fall in the use of breast milk in British neonatal units , exclusive formula feeding could account for an estimated 500 extra cases of necrotising enterocolitis each year . About 100 of these infants would die Whether breast milk influences later neurodevelopment  has been explored in non-r and omised studies , potentially confounded by social and demographic differences between feed groups . Here in a strictly r and omised prospect i ve multicentre trial , Bayley psychomotor and mental development indices ( PDI and MDI ) were assessed at 18 months postterm in survivors of 502 preterm infants assigned to receive , during their early weeks , mature donor breast milk or a preterm formula .  These diets were compared as sole enteral feeds or as supplements to the mother 's expressed breast milk . No differences in outcome at 18 months were seen between the two diet groups despite the low nutrient content of donor milk in 
    Output:
    