Human milk and the premature infant.

Area of Science:

• Neonatology
• Nutritional Science
• Pediatrics

Background:

• Human milk is optimal for term infants but lacks sufficient protein, energy, and minerals for preterm infants.
• Nutrient deficiencies in preterm infants fed unfortified human milk are linked to poor growth and long-term adverse outcomes.
• Human milk offers unique gastrointestinal maturation and immunological benefits crucial for infant development.

Purpose of the Study:

• To highlight the nutritional inadequacy of human milk for preterm infants.
• To emphasize the importance of fortifying human milk to support optimal growth and development.
• To discuss strategies for fortifying both mother's own milk and donor human milk.

Main Methods:

• Review of existing literature on human milk composition and infant nutrition.
• Analysis of growth and clinical outcomes in preterm infants fed fortified versus unfortified human milk.
• Evaluation of fortification practices for donor human milk.

Main Results:

• Unfortified human milk leads to poorer growth and nutrient deficiencies in preterm infants compared to specialized formulas.
• Appropriate fortification of human milk is associated with reduced rates of necrotizing enterocolitis, sepsis, and improved neurodevelopment.
• Donor human milk requires careful fortification, particularly if sourced from term infants.

Conclusions:

• Fortification of human milk is essential to meet the high nutritional demands of preterm infants.
• Optimized nutritional strategies are necessary to prevent extrauterine growth restriction and promote healthy development.
• Ensuring adequate nutrient intake through fortified human milk supports better clinical outcomes and long-term health.