Using Nature to Nurture: Breast Milk Analysis and Fortification to Improve Growth and Neurodevelopmental Outcomes in Preterm Infants

Abstract

Premature infants are born prior to a critical window of rapid placental nutrient transfer and fetal growth—particularly brain development—that occurs during the third trimester of pregnancy. Subsequently, a large proportion of preterm neonates experience extrauterine growth failure and associated neurodevelopmental impairments. Human milk (maternal or donor breast milk) is the recommended source of enteral nutrition for preterm infants, but requires additional fortification of macronutrient, micronutrient, and energy content to meet the nutritional demands of the preterm infant in attempts at replicating in utero nutrient accretion and growth rates. Traditional standardized fortification practices that add a fixed amount of multicomponent fortifier based on assumed breast milk composition do not take into account the considerable variations in breast milk content or individual neonatal metabolism. Emerging methods of individualized fortification—including targeted and adjusted fortification—show promise in improving postnatal growth and neurodevelopmental outcomes in preterm infants.

The Association Between Exclusive Breastfeeding and the Occurrence of Stunting Among Children Aged 12-60 Months in Community Health Centers in Yogyakarta City

“…Deficiencies in growth factors present in breast milk, such as epidermal growth factor and insulin-like growth factor, also contribute to disruptions in the growth and development of body cells, ultimately affecting overall growth and potentially leading to stunting. 12 The study conducted on children aged 12-60 months at the Yogyakarta City Community Health Center indicates that among children who were exclusively breastfed, 21 (36.8%) were still stunted, and among children who were not exclusively breastfed, 12 (21.4%) did not experience stunting. This demonstrates that stunting is influenced by various complex factors and is not solely dependent on exclusive breastfeeding.…”

“…11 Breast milk also contains immune factors that can protect children against stunting. Research by Goudet 12 mentions that breast milk contains immune substances such as immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM), which protect the baby's digestive tract from infections. Infections in the digestive tract can disrupt nutrient absorption and lead to stunting.…”

Nutrition, Diet and Healthy Aging

“…In line with the sentence reported on the Pan American Health organization website, "Healthy aging is a continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout the life course" (https://www.paho.org/en/healthy-aging (accessed on 20 December 2021)), prevention will have a central role in limiting age-related consequences. In this regard, Ottolini and collaborators [17] stress the influence of milk quality for feeding premature neonates on neurodevelopment. Additionally, as reported in the study protocol by Mohd Suffian and collaborators [18], there is an increasing interest in interventions aimed at promoting the prevention of frailty.…”

Nutrition, Diet and Healthy Aging

“…In line with the sentence reported on the Pan American Health organization website, “Healthy aging is a continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout the life course” ( (accessed on 20 December 2021)), prevention will have a central role in limiting age-related consequences. In this regard, Ottolini and collaborators [ 17 ] stress the influence of milk quality for feeding premature neonates on neurodevelopment. Additionally, as reported in the study protocol by Mohd Suffian and collaborators [ 18 ], there is an increasing interest in interventions aimed at promoting the prevention of frailty.…”