Geeta GATHWALA, Chandan Kumar SHAW, Prachi SHAW, Rajesh BATRA

Effect of fortification of breast milk on the growth of preterm neonates

Abstract. Human milk fortifiers (HMF) make up for the nutrient deficit required by preterm, low birth weight neonates. With the availability of a new HMF in India, it was pertinent to test this nutritional advantage in the Indian preterms fed with fortified human milk in terms the bioavailability of the important nutrients. METHODS: Sixty preterm neonates were randomly assigned in two groups of comparable gestational age and weight, the first fed with breast milk fortified with Lactodex fortifier and the second fed with EBM only. The changes in the mean levels of serum total protein and electrolytes (calcium, sodium, potassium (Na+, K+) and phosphorus), and blood urea in the two groups after two weeks were compared using the student’s t - test. RESULTS: After two weeks of fortification the mean total serum protein (study group 5.65±0.27 gm/L compared to 5.39±0.25 gm/L in the control group, p<0.001), serum calcium (study group at 9.24±0.32 mg/dl compared to 8.87±0.25 mg/dl in the control group p<0.001), phosphate (5.54±0.18 mg/dl in the study group versus 5.31±0.24 mg/dl in the control group, p<0.001) and Na+, K+ levels were significantly higher than the control group. The fortification was well tolerated. We concluded that using the new fortifier not only provides all the advantages of breast milk but also provides higher amounts of proteins and calcium necessary for sustaining growth and achieving intra-uterine accretion rates in the preterm neonates and is well tolerated.Key words: Preterm neonates and human milk fortifiers.

Keywords:

Preterm neonates and human milk fortifiers,

PDF

___

Zuppa AA, Girlando P, Scapillati ME, Maggio L, Romagnoli C, Tortorolo G. Effects on growth, tolerability and biochemical parameters of two different human milk fortifiers in very low birthweight newborns. Pediatr Med Chir 2004; 26: 45-49.
Porcelli P, Schanler R, Greer F, et al. Growth in human milk-Fed very low birth weight infants receiving a new human milk fo rtifier. Ann Nutr Metab 2000; 44: 2-10.
Reis BB, Hall RT, Schanler RJ, et al. Enhanced growth of preterm infants fed a new powdered human milk fortifier: A randomized, controlled trial. Pediatrics 2000; 106: 581-588.
Lucas A, Fewtrell MS, Morley R, et al. Randomized outcome trial of human milk fortification and developmental outcome in preterm infants. Am J Clin Nutr 1996; 6: 142-151.
Mileur LM, Chan GM, Gill G. Evaluation of liquid or powdered fortification of human milk on growth and bone mineralization status of preterm infants. J Pediatr Gastroenterol Nutr 1992; 15: 370-37
Hayashi T, Takeuchi T, Itabashi K, Okuyama K. Nutrient balance, metabolic response, and bone growth in VLBW infants fed fortified human milk. Early Hum Dev 1994; 39: 27-36.
Carey PE, Rowe JC, Goetz CA, et al. Growth and phosphorus metabolism in premature infants fed human milk, fortified human milk, or special premature formula. Am J Dis Child 1987; 14: 511515
Modanlou HD, Lim MO, Hansen JW, Sickles V. Growth, biochemical status, and mineral metabolism in very low birth weight infants receiving fortified preterm human milk. J Pediatr Gastroenterol Nutr 1986; 5: 762-767.
Kashyap S, Schulze KF, Forsyth M. Growth, nutrient retention, and metabolic response of low-birth-weight infants fed supplemented and unsupplemented preterm human milk. Am J Clin Nutr 1990; 52: 254-262.
Lucas A, Fewtrell MS, Morley R, et al. Randomized outcome trial of human milk fortification and developmental outcome in preterm infants. Am J Clin Nutr 1996; 64: 142-151
Polberger S, Raiha NCR, Juvonen P, et al. Individualized protein fortification of human milk for preterm infants: Comparison of ultrafiltrated human milk protein and a bovine whey fortifier. J Pediatr Gastroenterol Nutr 1999; 29: 332-338.
Hayashi T, Takeuchi T, Itabashi K, Okuyama K. Nutrient balance, metabolic response, and bone growth in VLBW infants fed fortified human milk. Early Hum Dev 1
Warner JT, Linton HR, Dunstan FDJ, Cartlidge PHT. Growth and metabolic responses in preterm infants fed fortified human milk or a preterm formula. Int J Clin Prac 1998; 52: 236-240.
Reis BB, Hall RT, Schanler RJ, et al. Enhanced growth of preterm infants fed a new powdered human milk fortifier: A randomized, controlled trial. Pediatrics 2000; 106: 581-588
Gross SJ. Bone mineralization in preterm infants fed human milk with and without mineral supplementation. J Pedi atr 1987; 111: 450-458.
Berseth CL, Van Aerde JE, Gross S, et al. Growth, efficacy, and safety of feeding an iron-fortified human milk fortifier. Pediatrics 2004; 114:699