Target Fortification of Breast Milk with Fat, Protein, and Carbohydrates for Preterm Infants

Rochow, Niels; Fusch, Gerhard; Choi, Arum; Chessell, Lorraine; Elliott, LouAnn; McDonald, Kimberley; Kuiper, Elizabeth; Purcha, Margaret; Turner, Steve; Chan, Emily; Xia, Meng; Fusch, Christoph

doi:10.1016/j.jpeds.2013.04.052

Cited by 139 publications

(163 citation statements)

References 28 publications

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“…8,13,19 Creamatocrit analysis can also be used. In a study by Rochow et al 25 (Table 2) individualised fortification was done using a stepwise approach, starting with determining the nutrient content in pooled human milk followed by standard fortification. The last step involved the addition of monomeric supplements to reach target levels of protein, fat and carbohydrate.…”

Section: Individualised Fortification: Target Fortificationmentioning

confidence: 99%

“…With the exception of increased serum urea levels in one study, 23 all changes in biochemical markers reported in the studies in Table 2, were not statistically significant. Kanmaz et al, 20 Biasini et al 23 and Rochow et al 25 are the only studies that reported on the incidence of metabolic acidosis, which were either not seen or did not occur more than prior to fortification.…”

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confidence: 99%

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Human milk fortification strategies for improved in-hospital growth of preterm infants

Kemp

Wenhold

2016

South African Journal of Clinical Nutrition

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Human milk is the preferred feed for preterm infants, yet it may need to be fortified for optimal growth and development. Standard fortification of human milk seldom meets the recommended intake of protein, leading to inadequate post-natal growth. This article aims to critically review different human milk fortification strategies with a focus on in-hospital growth of premature infants in resource-limited settings. Super, adjustable and target fortification are compared to standard fortification. Different growth outcome parameters limit comparability of findings, but super fortification and adjustable fortification present opportunities to explore. More uniform growth outcome assessment is recommended. Practical implementation and costeffectiveness in the local setting need to be investigated.

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Section: Individualised Fortification: Target Fortificationmentioning

confidence: 99%

mentioning

confidence: 99%

Human milk fortification strategies for improved in-hospital growth of preterm infants

Kemp

Wenhold

2016

South African Journal of Clinical Nutrition

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“…The addition of melatonin to formula feed may be most beneficial in premature infants, paralleling the common addition of proteins, fats and carbohydrates to breast milk for babies born preterm (107). The period to full term that is lost in premature infants would have been a period of high, continuous exposure to placental melatonin, perhaps indicating that all pretermer feeds should contain melatonin.…”

Section: Melatonin Addition To Formula Feedmentioning

confidence: 99%

Breastfeeding and the gut-brain axis: is there a role for melatonin?

Anderson¹,

Vaillancourt²,

Maes

et al. 2017

Biomolecular Concepts

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The benefits of breastfeeding over formula feed are widely appreciated. However, for many mothers breastfeeding is not possible, highlighting the need for a significant improvement in the contents of formula feed. In this article, the overlooked role of melatonin and the melatonergic pathways in breast milk and in the regulation of wider breast milk components are reviewed. There is a growing appreciation that the benefits of breastfeeding are mediated by its effects in the infant gut, with consequences for the development of the gut-brain axis and the immune system. The melatonergic pathways are intimately associated with highly researched processes in the gut, gut microbiome and gut-brain axis. As the melatonergic pathways are dependent on the levels of serotonin availability as a necessary precursor, decreased melatonin is linked to depression and depression-associated disorders. The association of breastfeeding and the gut-brain axis with a host of medical conditions may be mediated by their regulation of processes that modulate depression susceptibility. The biological underpinnings of depression include increased levels of pro-inflammatory cytokines, oxidative stress, kynurenine pathway activity and dysregulation of the hypothalamic-pituitary adrenal axis, all of which can decrease melatonergic pathway activity. The inclusion of the melatonergic pathways in the biological interactions of breast milk and gut development has significant theoretical and treatment implications, as well as being important to the prevention of a host of infant-, child-and adult-onset medical conditions.

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“…The data are similar for the other two macro-nutrients fat and lactose (data not shown). Data taken from [13] and reproduced with permission. Effect of target fortification on growth rates: squares represent 10 ELBW infants with target fortification (TFO), crosses represent 20 matched pair infants (±1 week of gestation, ±100 g of birth weight) with standard fortification.…”

mentioning

confidence: 99%

“…TFO prospectively identifies mother-infant pairs with insufficient levels of macronutrients in breast milk. Data and Figure according to [13] and reproduced with permission.…”

mentioning

confidence: 99%

Target Fortification of Breast Milk with Fat, Protein, and Carbohydrates for Preterm Infants

Cited by 139 publications

References 28 publications

Human milk fortification strategies for improved in-hospital growth of preterm infants

Human milk fortification strategies for improved in-hospital growth of preterm infants

Breastfeeding and the gut-brain axis: is there a role for melatonin?

Promoting healthy growth and nutrition in preterm infants: A challenge for clinicians and researchers

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