Application Of Human Milk Fortifier In Preterm Infants Fed Human Milk

Objective:Fortified human milk is the best choice for nutrition in premature infants. However there isn't any commercial human milk fortifier(HMF) product in China yet. Chinese people know little about HMF.A prospective,controlled trial was conducted to evaluate the short term growth,nutritional status of premature infants receiving preterm human milk supplemented with powdered human milk fortifier.Methods:Infants(n=24) with a birth weigh≤1800 g and gestational age≤36 weeks who were born at our hospital or transfered into our hospital within 12 hours after birth,and hospitalized in NICU from January 2008 to May 2008 were enrolled.They were classified as fortified human milk group(FHM group) and preterm formula group(control group).These premature infants in FHM group were fed human milk over 50%of total feeding volume and complementary preterm formula.Expressed breast milk of babies' own mothers was started to be enriched with HMF(FM85) when their feeding volume reached 100ml/kg.d.Those premature infants in control group were fed only preterm formula.In both groups,growth (daily weight,length and head circumference weekly),biochemical indices of nutritional status,enteral and parenteral intake,feeding tolerance,clinical history,and morbidity were evaluated serially.Results:There were no significant differences in infant characteristics or complications between FHM group(n=11,birth weight 1280 g,gestation 30.6 wk) and control group(n=13, birth weight 1436 g,gestation 31.6 wk).The average volume of human milk fed to the infants in FHM group was 81.6%of their total feeding volume during hospital stay.Human milk fortifier was added at 24.6 days of age,34 weeks of corrected age.The average growth velocity of weight(18.9 vs.17.1 g/kg.d,P=0.364),length(1.16 vs.1.00 cm/w,P=0.308) and head circumference(0.79 vs.0.61 cm/w,P=0.057) were similar in FHM group and control group.In the both groups,serum urea nitrogen at discharge was comparable.Serum albumin, prealbumin and phosphate values among these infants in FHM group were lower than those infants in control group.Serum alkaline phosphatase and calcium levels were higher in FHM group.There is no significant difference between the both groups in incidence of feeding intolerance,necrotizing enterocolitis(NEC) and nosocomial infection.Conclusion:These premature infants fed fortified human milk grew similarly as compared to those premature infants fed preterm formula.