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Does early compared to late fortification of human milk for preterm infants improve clinical outcomes?

Beth Godden1, Carmel T Collins2, Cathie Hilditch1,2,3

  • 1Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia.

Journal of Paediatrics and Child Health
|July 5, 2019
PubMed

Insights

Early fortification of breast milk in preterm infants is safe but does not significantly improve growth outcomes or reduce hospital stay. Further research is needed for long-term benefits.

Area of Science:

  • Neonatal Nutrition
  • Evidence-Based Medicine
  • Pediatric Growth

Background:

  • Preterm infants (<37 weeks' gestation) often require specialized nutritional support.
  • Breast milk fortification is a common practice to meet the high nutritional demands of preterm infants.
  • The optimal timing for initiating breast milk fortification remains a subject of clinical inquiry.

Purpose of the Study:

  • To evaluate the impact of early versus late fortification of breast milk on growth outcomes in preterm infants.
  • To determine if early fortification affects the length of hospital stay for preterm infants.
  • To answer the structured clinical question regarding early breast milk fortification in preterm neonates.

Main Methods:

  • Systematic literature search of major databases (MEDLINE, Embase, etc.) from 2000 onwards.
  • Inclusion of relevant articles addressing early versus late breast milk fortification in preterm infants.
  • Review of articles focused on growth outcomes and length of hospital stay.

Main Results:

  • Five full-text articles were included after screening 167 initial records.
  • Early fortification of breast milk was found to be safe and well-tolerated by preterm infants.
  • No significant improvement in growth outcomes at discharge or reduction in length of hospital stay was observed with early fortification.

Conclusions:

  • Current evidence suggests early breast milk fortification is safe but does not significantly impact short-term growth or hospital stay.
  • Further research is necessary to explore potential long-term benefits of early fortification on growth and neurodevelopment.
  • The findings highlight the need for continued investigation into optimal nutritional strategies for preterm neonates.
Abstract

Keywords:
foodfortifiedhuman/chemistryinfantmilknewborn

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