Improved Growth Velocity Using a New Liquid Human Milk Fortifier in Very Low Birth Weight Infants: A Multicenter,...

Area of Science:

• Neonatal Nutrition and Growth
• Pediatric Gastroenterology
• Clinical Pediatrics

Background:

• Optimizing growth and tolerance in very low birth weight (VLBW) infants is critical for long-term health outcomes.
• Human milk fortification is standard practice for VLBW infants, but different fortifier formulations may impact growth and tolerance.
• A novel liquid human milk fortifier (LHMF-NEW) was developed to potentially improve upon existing acidified liquid formulations (HMF-AL).

Purpose of the Study:

• To compare the growth velocity and feeding tolerance of VLBW infants receiving LHMF-NEW versus HMF-AL.
• To evaluate secondary outcomes including the incidence of late-onset sepsis, necrotizing enterocolitis, and metabolic acidosis.

Main Methods:

• A retrospective, multicenter study involving 515 VLBW infants across three neonatal intensive care units.
• Growth velocity (g/kg/d) during fortification was the primary outcome, analyzed using repeated measures regression.
• Feeding tolerance, late-onset sepsis, necrotizing enterocolitis, and metabolic acidosis were assessed as secondary outcomes using appropriate statistical tests.

Main Results:

• Infants receiving LHMF-NEW exhibited significantly higher growth velocity compared to those on HMF-AL (p=0.001), despite similar fluid, calorie, and protein intake.
• Feeding intolerance rates were comparable between the two fortifier groups.
• The incidence of metabolic acidosis was lower in the LHMF-NEW group, while late-onset sepsis and necrotizing enterocolitis rates did not differ significantly.

Conclusions:

• The LHMF-NEW promotes faster weight gain velocity in VLBW infants during fortification compared to the HMF-AL.
• LHMF-NEW is associated with a reduced risk of metabolic acidosis without compromising feeding tolerance, sepsis, or necrotizing enterocolitis rates.
• These findings suggest LHMF-NEW is a safe and effective option for improving growth outcomes in VLBW infants.