Human Milk-Derived Fortifier as Rescue Therapy in Very Preterm Infants Intolerant to Cow's Milk-Derived Fortifier

Area of Science:

• Neonatology
• Pediatric Nutrition
• Infant Critical Care

Background:

• Cow's milk-derived fortifier (CMDF) can cause feed intolerance in preterm infants.
• Alternative feeding strategies are crucial for managing nutritional needs in vulnerable neonates.
• Human milk-derived fortifier (HMDF) offers a potential solution for infants with CMDF intolerance.

Purpose of the Study:

• To evaluate the efficacy of human milk-derived fortifier (HMDF) as a rescue therapy for preterm infants intolerant to cow's milk-derived fortifier (CMDF).
• To assess feed tolerance and growth trends in infants switched to HMDF.
• To determine the safety and effectiveness of HMDF in a neonatal intensive care unit (NICU) setting.

Main Methods:

• Retrospective, descriptive study design.
• Inclusion criteria: very preterm infants (gestational age ≤ 32 wk) with feed intolerance, systemic symptoms, or thrombocytosis on CMDF.
• Rescue protocol involved switching to HMDF for 14 eligible infants.

Main Results:

• All 14 infants receiving HMDF rescue therapy tolerated feeds well and demonstrated positive growth trends.
• Thrombocytosis was present in 4 infants; 2 maintained elevated platelet counts despite HMDF.
• HMDF proved effective in managing CMDF intolerance, leading to improved outcomes until discharge.

Conclusions:

• Human milk-derived fortifier (HMDF) is an effective rescue therapy for preterm infants experiencing intolerance to cow's milk-derived fortifier (CMDF).
• Switching to HMDF supports positive growth and feed tolerance in this high-risk population.
• HMDF represents a valuable nutritional option for managing complex feeding issues in the NICU.