Proportionate Postnatal Growth in Preterm Neonates on Expressed Breast Milk Feeding With Selected Fortification

Area of Science:

• Neonatalogy
• Pediatric Nutrition
• Growth Monitoring

Background:

• Preterm neonates not exclusively fed human milk in the NICU often experience disproportionate growth.
• Limited data exist on the postnatal growth of Indian preterm neonates fed exclusively expressed breast milk (EBM).

Purpose of the Study:

• To describe postnatal growth changes (weight, length, head circumference) in preterm neonates receiving EBM with selective fortification in a NICU setting.
• To evaluate the impact of different fortification methods on growth parameters.

Main Methods:

• Prospective observational study design.
• Exclusive EBM feeding with early initiation and standardized progression.
• Breast milk fortification using human milk fortifier (HMF), calcium phosphate and multivitamins (CALVIT), or hindmilk (HM) based on gestational age.
• Monitoring of weight, length, and head circumference from admission to discharge.

Main Results:

• Ninety-three preterm neonates were studied; 36.6% were small for gestational age.
• Growth was assessed in neonates receiving EBM with HMF (34.3%), CALVIT (35.7%), or HM (28%) fortification.
• Significant differences in z-score changes for weight, length, and head circumference from birth to discharge (P = .001).
• Mean daily weight gain: 8.8-9.5 g/d; weekly length gain: 0.8-0.9 cm; weekly head circumference gain: 0.7 cm.

Conclusions:

• Exclusive EBM feeding with selected fortification promotes proportionate postnatal growth in preterm neonates during NICU admission.
• The study provides valuable growth data for Indian preterm infants on EBM.