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Using Nature to Nurture: Breast Milk Analysis and Fortification to Improve Growth and Neurodevelopmental Outcomes in
Katherine Marie Ottolini1, Elizabeth Vinson Schulz1, Catherine Limperopoulos2,3,4
1Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Insights
Premature infants often struggle with growth and development after birth. Individualized fortification of human milk shows promise for improving outcomes in these vulnerable neonates.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Developmental Neuroscience
Background:
- Premature infants miss critical third-trimester growth, leading to extrauterine growth failure and neurodevelopmental issues.
- Human milk is recommended for preterm infants but requires fortification to meet high nutritional demands.
- Standard fortification methods do not account for variations in breast milk composition or infant metabolism.
Purpose of the Study:
- To review emerging methods of individualized fortification for preterm infant nutrition.
- To highlight the potential of targeted and adjusted fortification strategies.
Main Methods:
- Review of current literature on preterm infant nutrition and fortification practices.
- Analysis of emerging individualized fortification techniques compared to standardized methods.
Main Results:
- Standard fortification may not optimize nutrient delivery due to variability in breast milk and infant needs.
- Individualized fortification approaches, such as targeted and adjusted fortification, offer a more tailored nutritional strategy.
Conclusions:
- Individualized fortification holds promise for enhancing postnatal growth in preterm infants.
- Personalized nutrition strategies may improve neurodevelopmental outcomes for preterm neonates.
Abstract:
Premature infants are born prior to a critical window of rapid placental nutrient transfer and fetal growth-particularly brain development-that occurs during the third trimester of pregnancy. Subsequently, a large proportion of preterm neonates experience extrauterine growth failure and associated neurodevelopmental impairments. Human milk (maternal or donor breast milk) is the recommended source of enteral nutrition for preterm infants, but requires additional fortification of macronutrient, micronutrient, and energy content to meet the nutritional demands of the preterm infant in attempts at replicating in utero nutrient accretion and growth rates. Traditional standardized fortification practices that add a fixed amount of multicomponent fortifier based on assumed breast milk composition do not take into account the considerable variations in breast milk content or individual neonatal metabolism. Emerging methods of individualized fortification-including targeted and adjusted fortification-show promise in improving postnatal growth and neurodevelopmental outcomes in preterm infants.
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