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Freeze-Dried Mother's Own Milk for Novel Fortification in a Late Preterm Infant with Complicated Intestinal Atresia
Allyson Ward1,2, Sarah M Reyes2,3, Berkley Luck2
1UChicago Medicine AdventHealth, Division of Women and Children's, Hinsdale, Illinois, United States.
Objective:
Feeding intolerance and growth failure commonly complicate recovery in infants with complicated intestinal atresia, often requiring prolonged human milk fortification after hospital discharge. Our objective was to describe a novel fortification strategy that enabled an exclusive mother's own milk (MOM) diet during postdischarge fortification in a medically complex infant with feeding intolerance.
Study Design:
This case report details the use of freeze-dried mother's own milk (FDMOM) to fortify expressed MOM in a late preterm infant with complicated atresia and congenital shortened bowel to resolve feeding intolerance and weight faltering. Freeze-drying of MOM took place at a commercial facility using SafeDry, a patented contact-free process. FDMOM was used to increase the caloric density of expressed MOM under medical supervision using a targeted fortification approach.
Results:
The patient tolerated unfortified MOM but developed severe fussiness, abdominal distention, and increased stooling upon fortification with hypoallergenic formulas. These symptoms resolved within 24 hours of transitioning to FDMOM fortification. Remarkably, the infant went from the 24th percentile for weight-for-age to the 66th percentile within 86 days.
Conclusion:
FDMOM fortification may represent a novel, well-tolerated strategy to support growth while maintaining an exclusive MOM diet in infants after complex gastrointestinal surgery and hospital discharge.
