Displacement of human milk during fortification: An experimental study

Area of Science:

• Neonatal Nutrition
• Pediatric Gastroenterology

Background:

• Human milk is the optimal nutrition for infants.
• Commercial human milk fortifiers (HMFs) and infant formulas are used to supplement or replace human milk.
• Quantifying the volume displaced by these products is essential for accurate nutritional intake assessment.

Purpose of the Study:

• To quantify the volume of human milk displaced by commercial HMFs and infant formulas.
• To assess the impact of energy density and product composition on milk displacement.

Main Methods:

• Commercial liquid HMFs and powder infant formulas were added to donor human milk.
• The fortified milk was stirred and weighed to determine the difference from unfortified milk.
• Displacement was calculated at various energy densities (22–30 kcal/ounce).

Main Results:

• Milk displacement was strongly correlated with energy density.
• Human milk-derived HMFs displaced more milk than bovine milk-derived HMFs at similar energy levels.
• Powder infant formulas displaced less milk than powder HMFs; hydrolyzed formulas displaced the least.

Conclusions:

• The volume of human milk displaced by HMFs and infant formulas varies significantly.
• Product composition (e.g., human vs. bovine milk origin, hydrolyzed) impacts displacement.
• Consideration of displacement is vital when choosing fortification or feeding strategies.