Premature newborns should be fed their mother’s milk rather than preterm formula. When compared to preterm formula, mother’s milk feeds are associated with lower incidence of necrotizing enterocolitis (NEC), late-onset sepsis, and probably chronic lung disease, as well as enhanced neurodevelopment. Every effort should be taken to support the birth mother’s effective nursing. This usually entails early and frequent breast milk expression with a breast pump, supplemented by targeted lactational counselling. Human milk feedings for VLBW newborns and other preterm infants at risk of growth failure must be supplemented with a human milk fortifier (HMF) to meet nutritional requirements.
Commercially accessible HMFs vary in a number of ways. Based on limited data from anecdotal reports, liquid HMF preparations are recommended due to concerns about Cronobacter sakazakii transmission in powdered HMFs. There have been no clear advantages demonstrated between protein hydrolysis or human-derived HMF and bovine-derived HMF.
References:
1. Gidrewicz DA, Fenton TR. A systematic review and meta-analysis of the nutrient content of preterm and term breast milk. BMC Pediatr 2014; 14:216.
2. Mead Johnson Nutrition. Enfamil® Human Milk Fortifier Powder. Available at: https://www.hcp.meadjohnson.com/s/product/a4R4J000000PpQiUAK/enfamil-human-milk-fortifier-powder (Accessed on August 17, 2021).
3. Mead Johnson Nutrition. Enfamil® Human Milk Fortifier Acidified liquid. Available at: https://www.hcp.meadjohnson.com/s/product/a4R4J000000PpR7UAK/enfamil-human-milk-fortifier-acidified-liquid (Accessed August 17, 2021).
4. Mead Johnson Nutrition. Enfamil® Liquid Human Milk Fortifier High Protein. Available at: https://hcp.meadjohnson.com/s/product/a4R4J000000PpQRUA0/enfamil-liquid-human-milk-fortifier-high-protein (Accessed on September 12, 2023).
5. Abbott. Similac® human milk fortifier concentrated liquid. Available at: https://abbottnutrition.com/similac-human-milk-fortifier-concentrated-liquid (Accessed on November 22, 2020).
6. Abbott. Similac® human milk fortifier hydrolyzed protein concentrated liquid. Available at: https://abbottnutrition.com/similac-human-milk-fortifier-hydrolyzed-protein-concentrated-liquid (Accessed on November 22, 2020).
7. Prolacta Bioscience. Preterm Nutrition Products. Available at https://www.prolacta.com/en/products/preterm-nutrition-products/ (Accessed on September 12, 2023).
8. Pietrzak-Fiećko R, Kamelska-Sadowska AM. The Comparison of Nutritional Value of Human Milk with Other Mammals’ Milk. Nutrients 2020; 12:1404.
9. Current recommendations of advisable nutrient intakes for fully enterally fed preterm VLBW infants. In: Pediatric Nutrition, 8th ed, Kleinman RE, Greer FR (Eds), American Academy of Pediatrics 2019.
10. Abrams SA, Committee on Nutrition. Calcium and vitamin D requirements of enterally fed preterm infants. Pediatrics 2013; 131:e1676.