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JOURNAL ARTICLE
Marie Bendix Simonsen, Susanne Soendergaard Kappel, Lise Aunsholt, Sören Möller, Per Torp Sangild, Gitte Zachariassen
OBJECTIVES: The safety and feasibility of human milk fortification with bovine colostrum (BC) were investigated in very preterm infants (FortiColos trial, NCT03537365). The BC product contained lower calcium, phosphate, and iron levels compared to the conventional fortifier (CF). We tested whether fortification with BC plus extra phosphate was sufficient to support the infants' mineral status assessed by blood biochemistry. METHODS: In a randomised controlled trial (FortiColos, NCT03537365), mineral status was compared after fortification with BC versus CF...
April 8, 2024: Journal of Pediatric Gastroenterology and Nutrition
#2
JOURNAL ARTICLE
Kristine Holgersen, Martin Bo Rasmussen, Itay Zamir, Lise Aunsholt, Gitte Zachariassen, Per Torp Sangild
BACKGROUND: Bovine colostrum (BC) contains a range of milk bioactive components, and it is unknown how human milk fortification with BC affects glucose-regulatory hormones in very preterm infants (VPIs). This study aimed to investigate the associations between hormone concentrations and fortification type, birth weight (appropriate/small for gestational age, AGA/SGA), milk intake, postnatal age, and body growth. METHODS: 225 VPIs were randomized to fortification with BC or conventional fortifier (CF)...
April 5, 2024: Pediatric Research
#3
JOURNAL ARTICLE
Georg Bach Jensen, Magnus Domellöf, Fredrik Ahlsson, Anders Elfvin, Lars Navér, Thomas Abrahamsson
BACKGROUND: Mortality and severe morbidity remain high in extremely preterm infants. Human milk-based nutrient fortifiers may prevent serious complications and death. We aimed to investigate whether supplementation with human milk-based fortifier (HMBF), as compared to bovine milk-based fortifier (BMBF), reduced the incidence of the composite outcome of necrotising enterocolitis (NEC), sepsis, and mortality in extremely preterm infants exclusively fed human milk. METHODS: In this multicentre, randomised controlled trial at 24 neonatal units in Sweden, extremely preterm infants born between gestational week 22 + 0 and 27 + 6 fed exclusively human breast milk (mother's own and/or donor milk), were randomly assigned (1:1) to receive targeted fortification with either HMBF or BMBF...
February 2024: EClinicalMedicine
#4
REVIEW
Radu Galis, Paula Trif, Diana Mudura, Jan Mazela, Mandy C Daly, Boris W Kramer, Shivashankar Diggikar
This meta-analysis assessed short-term outcomes after using human milk-derived fortifiers (HMFs) compared with bovine milk fortifiers (BMFs) in preterm infants fed an exclusive human milk (HM) diet, either mother's own milk (MOM) or donor human milk (DHM). We searched PubMed, Embase, Google Scholar, CENTRAL and CINHAL between January 2015 and August 2023 for studies reporting outcomes in infants with ≤28 weeks gestation and/or birthweight ≤ 1500 g on an exclusive human milk diet fortified with HMF versus BMF...
March 21, 2024: Nutrients
#5
COMMENT
Tarah T Colaizy, Brenda B Poindexter, Scott A McDonald, Edward F Bell, Waldemar A Carlo, Susan J Carlson, Sara B DeMauro, Kathleen A Kennedy, Leif D Nelin, Pablo J Sánchez, Betty R Vohr, Karen J Johnson, Dianne E Herron, Abhik Das, Margaret M Crawford, Michele C Walsh, Rosemary D Higgins, Barbara J Stoll, Namisavayam Ambalavanan, Myra H Wyckoff, Carl T D'Angio, George W Bugg, Robin K Ohls, Anne Marie Reynolds, Gregory M Sokol, Abbot R Laptook, Steven L Olsen, Jessica R White, Sudarshan R Jadcherla, Monika Bajaj, Prabhu S Parimi, Barbara Schmidt, Matthew M Laughon, John Barks, Kimberley A Fisher, Anna Maria Hibbs, Myriam Peralta-Carcelen, Noah Cook, Roy J Heyne, Brenna Cavanaugh, Ira Adams-Chapman, Janell Fuller, Michelle E Hartley-McAndrew, Heidi M Harmon, Andrea F Duncan, Abbey C Hines, Howard W Kilbride, Laurie A Richards, Nathalie L Maitre, Girija Natarajan, Andrea N Trembath, Martha D Carlson, William F Malcolm, Deanne E Wilson-Costello
IMPORTANCE: Maternal milk feeding of extremely preterm infants during the birth hospitalization has been associated with better neurodevelopmental outcomes compared with preterm formula. For infants receiving no or minimal maternal milk, it is unknown whether donor human milk conveys similar neurodevelopmental advantages vs preterm formula. OBJECTIVE: To determine if nutrient-fortified, pasteurized donor human milk improves neurodevelopmental outcomes at 22 to 26 months' corrected age compared with preterm infant formula among extremely preterm infants who received minimal maternal milk...
February 20, 2024: JAMA
#6
JOURNAL ARTICLE
Chiara Peila, Elena Spada, Sonia Deantoni, Matteo Borsani, Monica Asteggiano, Federica Chiale, Guido E Moro, Marzia Giribaldi, Laura Cavallarin, Ivan Cortinovis, Alessandra Coscia
Background: Since human milk contents does not meet the high need of very low birth weight infants, fortification of breast milk is a standard practice for this population. As donkey milk has been long considered for children allergic to cow's milk proteins due to its low allergic properties, a new donkey milk-derived fortifier (DF) has been recently evaluated as a valid alternative to bovine milk-derived fortifier (BF). It seems to improve feeding tolerance when compared with standard BF, with similar neurodevelopmental and auxological outcome at 18 months of age...
March 2024: Breastfeeding Medicine
#7
JOURNAL ARTICLE
Meera Khorana, Sareeporn Lamprasertkul, Suppawat Boonkasidecha
Background: Human milk (HM) is usually fortified using standard fortification (STD) to improve nutrition of preterm infants. However, the protein component may still be insufficient. HM could be further fortified with additional protein to improve STD. Objective: The primary objective was to compare changes in body weight (g/day, g/kg/day), length, and head circumference (mm/day) between preterm neonates fed HM with STD and those fed HM with adjustable fortification (ADJ). Methods: This study was a prospective, single-blinded, randomized controlled study in preterm infants of gestational age <32 weeks and weighing ≤1,800 g, admitted to the neonatal unit of the Queen Sirikit National Institute of Child Health...
March 15, 2024: Breastfeeding Medicine
#8
JOURNAL ARTICLE
Emmanuelle Lavassani, Kate A Tauber, Jennifer B Cerone, Jennifer Ludke, Upender K Munshi
BACKGROUND: Human milk-derived fortifier (HMDF) coupled with human milk feeding in extremely premature infants reduces the adverse outcome risks of early exposure to bovine milk ingredients but may not provide enough nutrients for adequate catch-up growth compared with bovine milk-derived fortifier (BMDF). OBJECTIVE: This study aims to compare HMDF and BMDF effects on growth parameters and serum 25-hydroxy vitamin D (25OHD) levels in preterm very low birth weight (VLBW) infants during the first 8 weeks of life...
2024: Frontiers in Pediatrics
#9
JOURNAL ARTICLE
Gaurav Gupta, A Murugesan, S Thanigainathan, B Adhisivam
OBJECTIVES: To compare the duration required to regain birth weight following early fortification of human milk vs. late fortification among preterm infants. METHODS: This randomized controlled trial included hemodynamically stable 120 preterm infants (≤32 wk of gestation). The intervention and comparator groups received standard fortification with human milk fortifier when enteral feeds reached 30 ml/kg/d (early fortification) and 80 ml/kg/d (late fortification) respectively...
February 28, 2024: Indian Journal of Pediatrics
#10
MULTICENTER STUDY
Junyan Han, Lan Zhang, Rong Zhang, Shuping Han, Jianxing Zhu, Xuefeng Hu, Jianhua Sun, Gang Qiu, Zhenghong Li, Weili Yan, Lijuan Xie, Xiuxia Ye, Xiaohui Gong, Liling Li, Fei Bei, Chan Liu, Yun Cao
BACKGROUND: Human milk fortifier (HMF) composition has been optimized recently. But clinical evidence of its safety and efficacy is limited in Chinese population. The aim of this study was to evaluate effects of a new HMF in growth, nutritional status, feeding intolerance, and major morbidities among very preterm (VPT) or very low birth weight (VLBW) infants in China. METHODS: VPT/VLBW infants admitted from March 2020 to April 2021 were prospectively included in the experimental (new HMF, nHMF) group, who received a new powdered HMF as a breast milk feeding supplement during hospitalization...
January 19, 2024: BMC Pediatrics
#11
JOURNAL ARTICLE
Grace O Adeniyi-Ipadeola, Kristi L Hoffman, Heeju Yang, Sara J Javornik Cregeen, Geoffrey A Preidis, Sasirekha Ramani, Amy B Hair
BACKGROUND: In very low birth weight (VLBW) infants, human milk cream added to standard human milk fortification is used to improve growth. This study aimed to evaluate the impact of cream supplement on the intestinal microbiome of VLBW infants. METHODS: Whole genome shotgun sequencing was performed on stool (n = 57) collected from a cohort of 23 infants weighing 500-1250 grams (control = 12, cream = 11). Both groups received an exclusive human milk diet (mother's own milk, donor human milk, and donor human milk-derived fortifier) with the cream group receiving an additional 2 kcal/oz cream at 100 mL/kg/day of fortified feeds and then 4 kcal/oz if poor growth...
January 16, 2024: Pediatric Research
#12
REVIEW
Thomas D R Sproat, Anirban Ghosh, Belal N Alshaikh
Freeze-drying (FD), or lyophilization, is commonly used to preserve foods. FD offers potential to create a human milk-derived human milk fortifier, and an alternative to freeze-storing human milk. However, processing human milk is known to affect its components. This scoping review explores the effect of FD on the; macronutrient, micronutrient, vitamin, bioactive components, microbes and anti-microbial factors in human milk, and studies where lyophilized human milk has been given to newborn infants. 48 articles were identified after full text review...
January 15, 2024: Journal of Perinatology: Official Journal of the California Perinatal Association
#13
JOURNAL ARTICLE
Mounika Pedaveeti, Faiza Iqbal, Jayashree Purkayastha, Shruthi K Bharadwaj, Anand Kumar Patil, Leslie Edward S Lewis
OBJECTIVES: To assess the growth pattern of preterm, very low birth weight (VLBW) appropriate for gestational age (AGA) infants on three different feeding regimens. METHODS: This prospective open label three-arm parallel randomized controlled trial was conducted at neonatal intensive care unit, Kasturba Hospital, Manipal. One hundred twenty VLBW (weight between 1000-1500 g and gestational age 28-32 wk) preterm AGA infants admitted from April 2021 through September 2022 were included...
January 11, 2024: Indian Journal of Pediatrics
#14
JOURNAL ARTICLE
Luke Mills, Karyn E Chappell, Robby Emsley, Afshin Alavi, Izabela Andrzejewska, Shalini Santhakumaran, Richard Nicholl, John Chang, Sabita Uthaya, Neena Modi
OBJECTIVE: Uncertainty exists regarding optimal supplemental diet for very preterm infants if the mother's own milk (MM) is insufficient. We evaluated feasibility for a randomised controlled trial (RCT) powered to detect important differences in health outcomes. METHODS: In this open, parallel, feasibility trial, we randomised infants 25+0-31+6 weeks of gestation by opt-out consent to one of three diets: unfortified human milk (UHM) (unfortified MM and/or unfortified pasteurised human donor milk (DM) supplement), fortified human milk (FHM) (fortified MM and/or fortified DM supplement), and unfortified MM and/or preterm formula (PTF) supplement from birth to 35+0 weeks post menstrual age...
December 13, 2023: Neonatology
#15
JOURNAL ARTICLE
Lyssa Lamport, Barry Weinberger, Diana Maffei
BACKGROUND: A common neonatal intensive care unit (NICU) discharge feeding strategy for preterm infants with growth failure who are feeding exclusively expressed human milk (EHM) has been to enrich mother's own milk (MOM) with formula powder or supplement 2-3 feeds per day with formula. However, this strategy displaces human milk from the diet. Our NICU recently adopted the standard practice of adding commercial human milk fortifier (HMF) to human milk feedings after discharge. We compared breastfeeding rates and growth using these two strategies...
December 8, 2023: Journal of Nutrition
#16
Vimal Vasu, Shaveta Mulla, Atisha Pandya, David Card, Martin J Shearer, Paul Clarke
All newborns need extra phylloquinone (vitamin K1 ; K1 ) to prevent vitamin K deficiency bleeding (VKDB). In preterm babies, the main sources are prophylactic K1 given at birth and parenteral and/or enteral feeding thereafter. Preterm babies are at risk of late-onset VKDB if ongoing K1 supplementation is inadequate. For extremely preterm infants fed an exclusive human milk diet, the low K1 content of human milk may predispose them to vitamin K deficiency. Human milk fortification with either bovine milk-derived fortifier or human milk-based fortifier (HMF) made from pooled donor milk is a widely used strategy to improve the micronutrient and growth status of preterm infants...
November 20, 2023: Journal of Thrombosis and Haemostasis: JTH
#17
REVIEW
Denise H Moreira, Sarah B Gregory, Noelle E Younge
Newborn infants require adequate nutrition to achieve full potential growth and development. Early life nutrition and health impacts long-term outcomes through adulthood. Human milk is the optimal source of nutrition during the first 6 months of life. However, infants admitted to the neonatal intensive care unit (NICU) often have comorbidities that create more or different nutrition demands than healthy newborns. There are different strategies to meet the nutrition needs of sick newborns, including use of parenteral nutrition, human milk fortifiers (HMFs), and infant formulas...
October 2023: Nutrition in Clinical Practice
#18
JOURNAL ARTICLE
Millie R Chang, Manas Tetarbe, Lorayne Barton, Rangasamy Ramanathan, Rowena Cayabyab
OBJECTIVE: Fortification of human milk (HM) with either human milk-derived fortifier (HMDF) or cow milk-derived fortifier (CMDF) is important in preterm infants. The objective is to compare the incidence of hypoglycemia, and biochemical values in infants less than 1,250 g at birth fed HMDF versus CMDF. STUDY DESIGN: It is a retrospective cohort study on infants less than 1,250 g at birth who were fed with HMDF or CMDF. Hypoglycemia was defined as blood glucose (BG) level equal to or less than 60 mg/dL within 72 hours of full enteral feeds when off total parenteral nutrition and intravenous fluids...
September 25, 2023: American Journal of Perinatology
#19
RANDOMIZED CONTROLLED TRIAL
Ariel A Salas, Emily Gunawan, Kelly Nguyen, Audrey Reeves, Victoria Argent, Amber Finck, Waldemar A Carlo
OBJECTIVES: Enteral nutrition with unfortified human milk during the first 2 postnatal weeks often leads to cumulative protein and energy deficits among preterm infants. Fortified human milk administered soon after birth could increase fat-free mass (FFM) and improve growth in these infants. METHODS: This was a masked, randomized trial. Starting on feeding day 2, extremely preterm infants 28 weeks or younger fed maternal or donor milk were randomized to receive either a diet fortified with a human-based product (intervention group) or a standard, unfortified diet (control group)...
September 1, 2023: Pediatrics
#20
REVIEW
Ting Ting Fu, Brenda B Poindexter
Multicomponent fortification is the standard of care to support short-term growth in preterm infants receiving human milk. There is no consensus regarding the optimal timing, method, or products used to fortify human milk. Both bovine milk-based and human milk-based human milk fortifiers are safe options, though increased fortification and enrichment may be needed to achieve adequate growth. Additional studies are needed to evaluate newer fortifier products and fortification strategies.
September 2023: Clinics in Perinatology
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