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. 2016 Oct 3;8(3):6632.
doi: 10.4081/pr.2016.6632. eCollection 2016 Sep 19.

Post Discharge Formula Fortification of Maternal Human Milk of Very Low Birth Weight Preterm Infants: An Introduction of a Feeding Protocol in a University Hospital

Abeer El Sakka  1 , Mohamed Sami El Shimi  1 , Kareem Salama  2 , Hend Fayez  3
Affiliations

Post Discharge Formula Fortification of Maternal Human Milk of Very Low Birth Weight Preterm Infants: An Introduction of a Feeding Protocol in a University Hospital

Abeer El Sakka et al. Pediatr Rep. .

Abstract

The objective of this study is to determine the growth parameters and nutritional biochemical markers and complications of fortification of human milk by post discharge formula of preterm very low birth weight newborns (VLBW). Fifty preterm infants less than 37 weeks with weight less than 1500 g were enrolled in the study. They received parental nutrition and feeding according to our protocol. When enteral feeding reached 100 cc/kg/day, infants were randomized into two groups: group I, Cases, n=25, where post discharge formula (PDF) was used for fortification, group II, Controls, n=25 with no fortification. Infants of both groups were given 50% of required enteral feeding as premature formula. This protocol was used until infants' weight reached 1800 g. Daily weight, weekly length and head circumference were recorded. Hemoglobin, albumin (Alb), electrolytes, blood urea nitrogen (BUN) and clinical complications were documented. Human milk fortification with PDF resulted in better growth with increase in weight 16.8 and 13.78 g/kg/day (P=0.0430), length 0.76 and 0.58 cm/week (P=0.0027), and head circumference of 0.59 and 0.5 cm/week (P=0.0217) in cases and controls respectively. Duration of hospital stay was less in cases (22.76 versus 28.52 days in Controls), P=0.02. No significant changes were found in serum electrolytes, BUN, or Alb between both groups. Hemoglobin was significantly higher in Cases, P=0.04. There were no significant clinical complications. Our feeding protocol of fortification of human milk with PDF in preterm very low birth weight newborns resulted in better growth and decrease in length of hospital stay. The use of PDF could be an alternative option for fortification of mothers' milk for preterm VLBW infants in developing countries with low resources.

Keywords: Breastfeeding; fortification; growth; hospital stay; preterm.

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Conflict of interest statement

the authors declare no potential conflict of interest.

Figures

Figure 1.
Figure 1.
Patient eligibility flow diagram.
Figure 2.
Figure 2.
Length of hospital stay in cases (1) and control (2) groups.
See this image and copyright information in PMC

References

    1. Schanler RJ, Lau C, Hurst NM, Smith EO. Randomized trial of donor human milk versus preterm formula as substitutes for mothers’ own milk in the feeding of extremely premature infants. Pediatrics 2005;116:400-6. - PubMed
    1. Atkinson SA. Effects of gestational age at delivery on human milk components. Jensen RG, ed. Handbook of milk composition. San Diego: Academic Press; 1995. pp 225-37.
    1. Lucas A, Cole TJ. Breast milk and neonatal necrotizing enterocolitis. Lancet 1990;336:1519-23. - PubMed
    1. Schanler RJ, Krebs NF, Mass SB, et al. Chapter 14: Breastfeeding and human milk for preterm infants. In: Breast feeding handbook for physicians. 2nd ed. Elk Grove Village, IL American College of Obstetric and Gynecology and American Academy of Pediatrics; 2014. pp 217-31.
    1. Butte NF, Garza C, Johnson CA, et al. Longitudinal changes in milk composition of mothers delivering preterm and term infants. Early Hum Dev 1984;9:153-62. - PubMed

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