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Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of
Anish Pillai1,2, Susan Albersheim3,4, Julie Matheson5
1Neonatal-Perinatal Medicine, British Columbia Women's and Children's Hospital, University of British Columbia, Vancouver, BC V6H 3N1, Canada. anish.pillai@cw.bc.ca.
Insights
A concentrated preterm formula (CPF) as a liquid human milk fortifier (HMF) was well-tolerated in preterm infants at risk for feeding intolerance. This liquid option supports adequate growth and offers an alternative to powder HMFs.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Clinical Research
Background:
- Concerns exist regarding the safety and tolerance of traditional powder human milk fortifiers (HMFs) for preterm infants.
- Optimizing nutrition in premature infants is crucial for their development and long-term health outcomes.
- Preterm infants are at increased risk for feeding intolerance, complicating nutritional management.
Purpose of the Study:
- To evaluate the tolerance and safety of a concentrated preterm formula (CPF) when used as a liquid human milk fortifier (HMF).
- To assess CPF's suitability for preterm infants with a history of intolerance to powder HMFs.
- To determine if CPF facilitates adequate growth in this vulnerable population.
Main Methods:
- Prospective enrollment of preterm infants over 18 months requiring HMF.
- Administration of human milk fortified with CPF to infants with prior HMF intolerance.
- Monitoring of feeding tolerance, anthropometry, growth velocity, and serum biochemistry.
- Surveillance for serious adverse events including mortality, necrotizing enterocolitis (NEC), and sepsis.
Main Results:
- Twenty-nine preterm infants received CPF-fortified milk.
- The primary indication for CPF use was previous intolerance to powder HMF.
- Feeding intolerance occurred in 4 infants (13.8%) receiving CPF.
- Satisfactory growth velocity (15.9 g/kg/day) was observed after CPF addition.
- No serious adverse events like NEC or sepsis were specifically attributed to CPF in this cohort.
Conclusions:
- Concentrated preterm formula (CPF) as a liquid HMF appears well-tolerated and safe in preterm infants at high risk for feeding intolerance.
- CPF supports adequate growth, providing a viable alternative to powder HMFs.
- This liquid fortification option is valuable for managing nutrition in challenging preterm infants, especially where HMF choices are limited.
Abstract:
There are concerns around safety and tolerance of powder human milk fortifiers to optimize nutrition in preterm infants. The purpose of this study was to evaluate the tolerance and safety of a concentrated preterm formula (CPF) as a liquid human milk fortifier (HMF) for premature infants at increased risk of feeding intolerance. We prospectively enrolled preterm infants over an 18-month period, for whom a clinical decision had been made to add CPF to human milk due to concerns regarding tolerance of powder HMF. Data on feed tolerance, anthropometry, and serum biochemistry values were recorded. Serious adverse events, such as mortality, necrotizing enterocolitis (NEC), and sepsis, were monitored. A total of 29 babies received CPF fortified milk during the study period. The most common indication for starting CPF was previous intolerance to powder HMF. Feeding intolerance was noted in 4 infants on CPF. The growth velocity of infants was satisfactory (15.9 g/kg/day) after addition of CPF to feeds. The use of CPF as a fortifier in preterm babies considered at increased risk for feed intolerance seems well tolerated and facilitates adequate growth. Under close nutrition monitoring, this provides an additional option for human milk fortification in this challenging subgroup of preterm babies, especially in settings with limited human milk fortifier options.
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