Enteral Bioactive Factor Supplementation in Preterm Infants: A Systematic Review

Mank et al., 2020 | Nutrients | Meta Analysis

Citation

Mank Elise, Naninck Eva F G, ... van den Akker Chris H P. Enteral Bioactive Factor Supplementation in Preterm Infants: A Systematic Review. Nutrients. 2020-Sep-24;12(10). doi:10.3390/nu12102916

Abstract

Feeding preterm infants with mother's own milk is associated with a reduction in postnatal complications and an improved neurocognitive outcome. Therefore, the bioactive factor composition of human milk has been used as a tool for the development of nutritional supplements with a potential prophylactic or therapeutic effect. The aim of this systematic review was to provide an overview on bioactive factors which have been studied as supplement to enteral nutrition in randomized controlled trials, and to provide an overview of ongoing trials. MEDLINE, EMBASE, CENTRAL, and clinical trial registers were searched. Studies on the antimicrobial protein lactoferrin were excluded as these were summarized very recently in three separate systematic reviews. Studies on vitamins D, K and iron were also excluded as they are already incorporated in most international guidelines. We identified 17 different bioactive factors, which were investigated in 26 studies. Despite the encouraging potential effects of several bioactive factors, more high-quality studies with a sufficient number of preterm infants are required before a certain factor may be implemented into clinical practice. Three large trials (n > 500) that investigate the effects of either enteral insulin or vitamin A are currently ongoing and could provide more definite answers on these specific supplements.

Key Findings

Three large trials (n > 500) that investigate the effects of either enteral insulin or vitamin A are currently ongoing and could provide more definite answers on these specific supplements.

Outcomes Measured

Requires manual extraction

Population

Field	Value
Population	See abstract
Sample Size	26
Age Range	See abstract
Condition	cognitive

MeSH Terms

Child Development
Databases, Factual
Dietary Supplements
Enteral Nutrition
Humans
Infant
Infant Nutritional Physiological Phenomena
Infant, Premature
Milk, Human
Randomized Controlled Trials as Topic
Treatment Outcome

Evidence Classification

Level: Meta Analysis
Publication Types: Journal Article, Meta-Analysis, Systematic Review
Vertical: vitamin-a

Provenance

PMID: 32987621
DOI: 10.3390/nu12102916
PMCID: PMC7598610
Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09