How long to fortify breast milk

Proven to be effective in optimizing growth and protein intake with a RCT. A real individualization method taking into consideration each infant's protein requirement. All macronutrients can be supplemented. Bedside HM analyzers are required. May be labor intensive. Supplementation is done according to the population recommendations, does not take into consideration that each individual infant's requirement may be different. Standard Std Fortification This is the most widely used fortification method.

Table 6 The products required and the threshold values of the metabolic marker used for the Adjustable ADJ fortification method A multi-nutrient fortifier 2. Table 7 The scheme for adjustable fortification updated in Targeted Fortification The concept of targeted fortification is to analyze macronutrient composition of HM and to fortify it in such a way that each infant always receives the amount of nutrient that is suggested in population-based recommendations.

Table 8 Nutrient interventions in the randomized controlled trials addressing the effects of fortifying human milk post discharge — Conclusions-Comments, Recommendations Conclusions-Comments. Conflict of Interest Statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. References 1. Protein intake and neurodevelopmental outcomes.

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The effect of early human diet on caudate volumes and IQ. Pediatr Res. Infant growth before and after term: effects on neurodevelopment in preterm infants. First-week protein and energy intakes are associated with month developmental outcomes in extremely low birth weight infants.

Pediatr Clin North Am. Postnatal growth in preterm infants and later health outcomes: a systematic review. Acta Paediatr. Nutrition and neurodevelopmental outcomes in preterm infants: a systematic review. Both extrauterine and intrauterine growth restriction impair renal function in children born very preterm. Kidney Int. The relationship of poor linear growth velocity with neonatal illness and two-year neurodevelopment in preterm infants.

Greater early gains in fat-free mass, but not fat mass, are associated with improved neurodevelopment at 1 year corrected age for prematurity in very low birth weight preterm infants. Eunice kennedy shriver national institute of child health and human development neonatal research network.

Weight growth velocity and postnatal growth failure in infants to grams: Postnatal growth failure in very low birthweight infants born between and Neonatal data analysis unit and the preterm growth investigator group.

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Semin Perinatol. Donor human milk for preterm infants: current evidence and research directions. J Pediatr Gastroenterol Nutr. Intake of own mother's milk during the first days of life is associated with decreased morbidity and mortality in very low birth weight infants during the first 60 days of life.

Role of human milk in extremely low birth weight infants' risk of necrotizing enterocolitis or death. J Perinatol. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products.

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Policy of feeding very preterm infants with their mother's own fresh expressed milk was associated with a reduced risk of bronchopulmonary dysplasia. BMJ Open. National institute of child health and human development national research network. Neurodevelopmental outcomes of preterm infants fed human milk: a systematic review. American academy of pediatrics; european society for pediatric gastroenterology, hepatology, and nutrition.

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Individualized fortification influences the osmolality of human milk. Frontiers Pediatr. Effects on fatty acid metabolism of a new powdered human milk fortifier containing medium-chain triacylglycerols and docosahexaenoic acid in preterm infants. Growth and nutritional biomarkers of preterm infants fed a new powdered human milk fortifier: a randomized trial.

Nutritional adequacy of a novel human milk fortifier from donkey milk in feeding preterm infants: study protocol of a randomized controlled clinical trial. Nutr J. Composition and variation of macronutrients, immune proteins, and human milk oligosaccharides in human milk from nonprofit and commercial milk banks. J Hum Lact. Randomized trial of human milk cream as a supplement to standard fortification of an exclusive human milk-based diet in infants — g birth weight.

Premature infants —1, g birth weight supplemented with a novel human milk-derived cream are discharged sooner. Breastfeed Med. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products.

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OptiMoM feeding group. Am J Clin Nutr. Perrin MT. Donor human milk and fortifier use in United States Level , and 4 neonatal care hospitals. Guidelines for the establishment and operation of a donor human milk bank. J Mater Fetal Neonatal Med. Nutritional efficacy of preterm formula with a partially hydrolyzed protein source: a randomized pilot study. Atopic eczema and preterm birth. Arch Dis Child. Early diet of preterm infants and development of allergic or atopic disease: randomized prospective study.

Br Med J. Allergic diseases among very preterm infants according to nutrition after hospital discharge. But when it comes to calories, needing fortification of breast milk is rare.

The way to know if baby needs some extra calories is by his or her growth. If baby is growing, no supplementation is needed. If baby is not growing according to your pediatrician , baby needs supplementation. This most often occurs in premature babies when they experience rapid growth spurts. Fortifying breast milk is the first-line treatment for increasing calories in babies under six months of age.

This allows the baby to still receive all the benefits of breast milk plus additional nutrients, as opposed to the exclusive use of formula first. Commercially prepared human breast milk fortifiers are available in liquid and powder form. Breast milk can also be fortified by adding powdered formula to it and giving the combination in a bottle. Rochow, N.

Challenges in breast milk fortification for preterm infants. Henriksen, C. Growth and nutrient intake among very-low-birth-weight infants fed fortified human milk during hospitalisation.

British journal of nutrition , 8 , Maas, C. Early feeding of fortified breast milk and in-hospital-growth in very premature infants: a retrospective cohort analysis. BMC pediatrics , 13 1 , Radmacher, P. Fortification of human milk for preterm infants. Gomella, T. Assessment of gestational age. Neonatology management, procedures, on-call problems, diseases, and drugs.

New York: McGraw Hill , Mimouni, F. The use of multinutrient human milk fortifiers in preterm infants: a systematic review of unanswered questions. Clinics in perinatology , 44 1 , Shah, S. The Journal of pediatrics , , Tillman, S. Evaluation of human milk fortification from the time of the first feeding: effects on infants of less than 31 weeks gestational age.

Journal of Perinatology , 32 7 , Taheri, P. Is early breast milk fortification more effective in preterm infants? Journal of perinatal medicine , 45 8 , This article appeared previously in the Spring issue of Neonatal Intensive Care.

About the Author Sandy Sundquist Beauman has over 30 years of experience in neonatal nursing. About Contact Donate Login. Among NICU graduates, fortification by adding formula powder to expressed breastmilk is associated with continued breastmilk feedings at 4 months as compared to supplementation with bottles of formula. What is the difference between fortifying breastmilk with formula powder versus supplementing with a few bottles of formula a day for premature infants upon hospital discharge?

What do you think are accurate statements based on this study regarding the differences in growth between those who received breastmilk with formula powder supplementation vs those who received bottles of breastmilk? Choose none, 1 or both:. The premature infants who received bottles of breastmilk with formula powder weighed less at 4 months compared to those who received bottles of formula. The premature infants who received bottles of breastmilk with formula powder had a higher likelihood of growth restriction as compared to those who received bottles of formula.

Abstract Background Effects of breast milk BM enhancement on long-term BM feeding in preterm infants discharged from the neonatal intensive care unit NICU have not been examined previously. Leave a Reply Cancel reply Your email address will not be published.