Adjustable fortification of human milk fed to preterm infants: does it make a difference?

Arslanoğlu, Sertaç; Moro, Guido; Ziegler, Ekhard E.

doi:10.1038/sj.jp.7211571

Cited by 218 publications

(232 citation statements)

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“…The original study 18 was a prospective, randomized open-label trial comparing a new adjustable fortification regimen (ADJ) with a standard (fixed) fortification regimen (STD) in preterm infants.…”

Section: Study Design and Subjectsmentioning

confidence: 99%

“…Aliquots of the prepared milk were removed on 2 days of each week, combined to form weekly pools and analyzed as described. 18 The exact feeding volume, the level of fortification and the percentage of mother's own milk and donor milk were recorded daily.…”

Section: Feedingsmentioning

confidence: 99%

“…In the course of a recent study 18 that tested a new method designed to ensure delivery of adequate amounts of nutrients to very low birthweight infants (adjustable fortification), the actual concentrations of protein and fat of human milk were determined. We now use this information to obtain estimates of the disparity between actual nutrient intakes and assumed nutrient intakes of preterm infants.…”

Section: Introductionmentioning

confidence: 99%

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Preterm infants fed fortified human milk receive less protein than they need

2009

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Objective: The aim of this study was to compare the actual nutrient intakes observed in a previously reported study with assumed nutrient intakes based on the customary assumptions about the composition of human milk.Study Design: Fortified human milk is assumed to provide adequate amounts of nutrients for premature infants. This assumption holds if milk has the composition of milk expressed by mothers of premature infants during weeks 2 to 3 of lactation. The assumption does not necessarily hold for milk expressed after 2 to 3 weeks lactation. It also does not hold for donor milk, which is typically provided by mothers of term infants. The size of the disparity between assumed and actual nutrient intakes is not known. Actual nutrient intakes were available for 32 preterm infants participating in the study. Assumed nutrient intakes were calculated for these infants by substituting assumed nutrient concentrations for observed nutrient concentrations. Data were compared separately for each of the 3 study weeks.Result: Actual protein intakes were significantly and consistently lower than assumed protein intakes during each study week. The differences in mean intakes were large, ranging from 0.5 to 0.8 g kg À1 per day. Differences in energy intake were small and not consistently significant.Conclusion: Actual intakes of protein by preterm infants fed fortified human milk are substantially lower than assumed intakes. The discrepancy may in part explain why preterm infants frequently show postnatal growth failure.

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Section: Study Design and Subjectsmentioning

confidence: 99%

Section: Feedingsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Preterm infants fed fortified human milk receive less protein than they need

2009

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“…22 Individual fortification, which consists in the analysis of the composition of maternal milk and its supplementation using the necessary amount of nutrients with the purpose of making the diet meet the needs of the very low birth weight preterm infant, is suggested in another study. 23 According to these authors, individual fortification makes it possible to establish a more accurate amount of calories and proteins, also reducing the risk of hyperosmolality.…”

Section: Discussionmentioning

confidence: 99%

Efeitos do uso de aditivo no leite humano cru da própria mãe em recém-nascidos pré-termo de muito baixo peso

Martins

Krebs

2009

J. Pediatr. (Rio J.)

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Objective: To compare the weight and height gain and the frequency of clinical complications in preterm newborns weighing less than 1,500 g, exclusively fed human milk or fortified human milk until reaching 1,800 g. Methods:Prospective double-blind randomized controlled trial involving 40 preterm infants weighing < 1,500 g at birth and ≤ 34 weeks of gestational age, admitted to a neonatal intensive care unit from August 2005 to April 2007.Preterm infants were randomized into two groups: control (human milk) and intervention (fortified human milk).Fortifiers were added to manually expressed human milk when feeding volume reached 100 mL/kg/day until newborns

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“…Adjustable fortification was described by Arslanoglu et al [57]. The investigators used BUN as their signal for making adjustments (either more or less fortifier).…”

Section: Fortificationmentioning

confidence: 99%

Donor Human Milk: No Longer A Place For Formula in the Neonatal Intensive Care Unit?

Adamkin

Radmacher

2014

Curr Pediatr Rep

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Human milk is the best food for human infants, including those born preterm. Human milk feeding benefits the preterm infant by improving mental and motor development, decreasing the risk of necrotizing enterocolitis, sepsis, and retinopathy of prematurity during the postnatal period spent in the Neonatal Intensive Care Unit. In order to support the increased nutrient requirements of these infants, human milk must be fortified. In the absence of a mother's own milk, donor human milk is becoming a more commonly used replacement for bovine-based formula, especially in the tiniest patients. While donor human milk has been shown to convey many of the benefits of mother's own milk, it is generally lower in protein and calories than preterm milk and may require fortification in different proportions. This report discusses the evidence for donor human milk in the nutritional support of the preterm infant.

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Adjustable fortification of human milk fed to preterm infants: does it make a difference?

Cited by 218 publications

References 50 publications

Preterm infants fed fortified human milk receive less protein than they need

Preterm infants fed fortified human milk receive less protein than they need

Efeitos do uso de aditivo no leite humano cru da própria mãe em recém-nascidos pré-termo de muito baixo peso

Donor Human Milk: No Longer A Place For Formula in the Neonatal Intensive Care Unit?

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