Australia: Study on Smell and Taste of Milk in Preterm Infants

A recent study published in the journal JAMA Pediatrics showed that smell and taste of milk with tube feeding did not improve weight at discharge in preterm infants. However, the combination is a simple and low-cost intervention with some potential benefits and no apparent adverse effects.

According to the findings from a randomized clinical trial, exposure to smell and taste improved head circumference and length at 36 weeks' postmenstrual age (PMA), but not at discharge.

Preterm birth is common and often associated with poor health outcomes. After the birth of such infants, detailed attention is given to nutrition as improved weight gain and head growth may lead to better health outcomes and improved long-term neurodevelopment. Preterm infants face specific problems: they cannot coordinate suck and swallow and are therefore tube fed.

Smell and taste of food activate gut motility, increase food anticipation, and stimulate digestion and metabolism. Despite poor growth of many preterm infants in neonatal intensive care units, the smell and taste of milk with tube feeding are not generally considered a regular component of care.

Against the above background, Friederike Beker, The University of Queensland, South Brisbane, Queensland, Australia, and colleagues aimed to determine the effect of smell and taste of milk with tube feeding on weight z scores at discharge from the hospital.

For this purpose, the researchers conducted a randomized, controlled, nonblinded, superiority trial at 2 perinatal centers between May 9, 2017, and February 1, 2020. Eligible infants (n = 659) were born at less than 29 weeks' postmenstrual age (PMA) and/or with a birth weight of less than 1250 g.

Out of 658 infants, 396 were randomly assigned to receive either the smell and taste of milk with each tube feeding (n=196) or routine care (n=200) without the provision of smell and taste of milk.

The primary outcome was weight z score at discharge from any hospital. Secondary outcomes included anthropometric measures at predefined time points, time to full enteral feeds, and other health outcomes associated with prematurity.

Key Findings

• Mean weight z scores at discharge were −0.87 for the treatment group and −0.97 for the control group.
• The mean difference in z scores between the treatment and control groups at 36 weeks' PMA was 0.21 for head circumference and 0.26 for length.
• There were no clinically notable differences between the study groups for any other anthropometric, feeding, or health outcomes.

Regular exposure to the smell and taste of milk is a simple and inexpensive intervention with potential benefits and no apparent adverse effects, the researcher summed up.

Reference

Beker F, Liley HG, Hughes IP, et al. Effects on Growth of Smell and Taste of Milk During Tube Feeding of Preterm Infants: A Randomized Clinical Trial. JAMA Pediatr. 2021;175(11):1115–1123. doi:10.1001/jamapediatrics.2021.2336