SynthesisArchives of disease in childhood. Fetal and neonatal edition2019
Milk feed osmolality and adverse events in newborn infants and animals: a systematic review.
Synthesis in Archives of disease in childhood. Fetal and neonatal edition, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07549360 (Leveraging Optimal Tolerance in Undernourished Infants to Support Growth), which is not on this map. Cited by 30 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Leveraging Optimal Tolerance in Undernourished Infants to Support Growth
Who cites it
30 citing papers in PubMed, 4 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Guideline
- Donor human milk for preventing necrotising enterocolitis in very preterm or very low-birthweight infants.The Cochrane database of systematic reviews · 2024Pooled it
- Enteral Feeding Interventions in the Prevention of Necrotizing Enterocolitis: A Systematic Review of Experimental and Clinical Studies.Nutrients · 2021Pooled it
- Formula versus maternal breast milk for feeding preterm or low birth weight infants.The Cochrane database of systematic reviews · 2019Pooled it
- A novel human milk fortifier supports adequate growth in very low birth weight infants: a non-inferiority randomised controlled trial.Archives of disease in childhood. Fetal and neonatal edition · 2025Trial
- Randomized pilot study comparing standard vs high-calorie feeding in infants with Neonatal Opioid Withdrawal Syndrome.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Article
- Osmolality of fortified human milk with contemporary human milk fortifiers.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026Article
- Observational
- Evaluating the Safety of Gastrointestinal Contrast Agents in Pediatric Patients: A Retrospective Study.Cureus · 2025Article
- Article
- Term infant formula macronutrient composition: An update for clinicians.Journal of pediatric gastroenterology and nutrition · 2025Review
- The fifty billion dollar question: does formula cause necrotizing enterocolitis?Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- Osmolality of compounded oral liquids for pediatrics.European journal of pediatrics · 2025Article
- A low-fat amino acid diet reverses intestinal failure and shows good growth trends in five infants with diacylglycerol transferase 1 (DGAT1) deficiency: a prospective cohort study.Lipids in health and disease · 2024Article
- [Interpretation of key points from the "Expert Consensus on Diagnosis and Management of Neonatal Cow Milk Protein Allergy (2023)"].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2024Article
- Bovine milk consumption affects the transcriptome of porcine adipose stem cells: Do exosomes play any role?PloS one · 2024Article
- Phenylalanine free infant formula in the dietary management of phenylketonuria.Orphanet journal of rare diseases · 2023Article
- The association between plasma osmolality and in-hospital mortality in the first 24 h after neonatal intensive care unit admission.Frontiers in pediatrics · 2023Article
- What Are the Minimal Feeds Required for Starting Enteral Ibuprofen in Preterm Infants with PDA?Pediatric reports · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh feed osmolality (or osmolarity) is often suggested to be linked with adverse gastrointestinal events in preterm infants.
aimTo systematically review the literature on milk feed osmolality and adverse gastrointestinal events in newborn and low birthweight infants and animals.
methodsMEDLINE, Embase, CAB Abstracts, Current Contents, BIOSIS Previews and SciSearch were searched from inception to May 2018 to identify potentially relevant studies. INCLUSION CRITERIA: randomised controlled or observational studies of newborn and low birthweight infants or animals investigating the effects of milk-based feeds with different osmolalities. Only full-text, English-language papers were included.
resultsTen human and six animal studies met the inclusion criteria. Of human studies, seven reported no differences in adverse events with varying feed osmolalities; one reported delayed gastric emptying with feed osmolarity of 539 mOsm/L compared with lower levels; one reported higher necrotising enterocolitis (NEC) incidence with feed osmolarity of 650 mOsm/L compared with 359 mOsm/L; one found higher NEC incidence with the lowest feed osmolality (326 mOsm/kg compared with 385 mOsm/kg). Of animal studies, two reported delayed gastric emptying with feed osmolarity >624 mOsm/L, one reported decreased survival due to dehydration with dietary osmolarities ≥765 mOsmol/L and none reported increased NEC incidence with differing feed osmolalities. No clear mechanisms were found, and diet composition differences limited the interpretations regarding the independent impact of osmolality.
conclusionsThere is no consistent evidence that differences in feed osmolality in the range 300-500 mOsm/kg are associated with adverse gastrointestinal symptoms in neonates.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.