Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan-Feb;35(1):277-281.
doi: 10.12669/pjms.35.1.337.

What should be the protein target for adjustable Human Milk fortification in premature infants?

Bayram Ali Dorum  1 , Hilal Ozkan  2 , Salih Cagri Cakir  3 , Nilgun Koksal  4 , Gizem Ezgi Sen  5
Affiliations

What should be the protein target for adjustable Human Milk fortification in premature infants?

Bayram Ali Dorum et al. Pak J Med Sci. 2019 Jan-Feb.

Abstract

Objective: To assess the short- and long-term effects of the adjustable fortification (ADJ) regimen on growth parameters in premature infants and to evaluate the amount of protein supplements given to reach the targeted blood urea nitrogen (BUN) levels.

Methods: In this retrospective study, preterm babies who were born at ≤32 weeks gestational age and fed with human milk, were evaluated in two groups. Infants in Group-I were fed only standard fortification (STD). Infants in Group-II were fed the ADJ regimen. The study was conducted between 2011 and 2016.

Results: There were 123 infants in the STD group and 119 in the ADJ group. The mean gestational age of the patients in Group-I was 29.7±1.8 weeks, and mean birth weight was 1266.1±347.1 g. The mean gestational age of the patients in Group-II was 29.5±1.9 weeks, and the mean birth weight was 1217.5±345.5 g. The daily increase in weight and weekly increase in HC were significantly higher in the ADJ group infants. Weight and HC of infants in the ADJ group were significantly higher at 40 weeks. At one year corrected age, weight, length, and HC measurements of both groups were similar. In Group-II, 63% of patients required additional protein supplementation up to 1.6 g/day to achieve the target BUN levels.

Conclusion: A higher protein intake through the ADJ regimen improves the physical growth rate of premature infants in the NICU and after discharge. However, sometimes, the targeted growth and BUN values cannot be achieved despite the administration of protein at the recommended increased doses. Increasing protein supplementation up to 1.6 g/day is safe, feasible, and beneficial for these infants.

Keywords: Adjustable fortification; Human milk fortification; Newborn; Preterm.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors declared no conflict of interest.

Figures

Fig.1
Fig.1
Flow chart of the participant infants.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Wagner J, Hanson C, Anderson-Berry A. Considerations in Meeting Protein Needs of the Human Milk–Fed Preterm Infant. Adv Neonatal Care. 2014;14(4):281–289. doi:10.1097/ANC.0000000000000108. - PubMed
    1. Radmacher PG, Adamkin DH. Fortification of human milk for preterm infants. Semin Fetal Neonatal Med. 2017;22:30–35. doi:10.1016/j.siny.2016.08.004. - PubMed
    1. Su BH. Optimizing nutrition in preterm infants. Pediatr Neonatol. 2014;55(1):5–13. doi:10.1016/j.pedneo.2013.07.003. - PubMed
    1. Ziegler EE, Thureen PJ, Carlson SJ. Aggressive nutrition of the very low birth weight infant. Clin Perinatol. 2002;29(2):225–244. - PubMed
    1. Ziegler EE. Protein requirements of very low birth weight infants. J Pediatr Gastroenterol Nutr. 2007;45(Suppl 3):S170–174. doi:10.1097/01.mpg.0000302966.75620.91. - PubMed

LinkOut - more resources