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Impact of fortifiers on donor milk nutrient composition: An experimental study
Kimberly Mansen1, Hannah Sanders1, Sarah N Taylor2
1Integrated Maternal and Child Health and Development, PATH, Seattle, Washington, USA.
JPEN. Journal of Parenteral and Enteral Nutrition
|April 6, 2026
Summary
Commercial fortifiers significantly alter nutrient levels in donor human milk for preterm infants, often leading to deficiencies or excesses. Developing better fortifiers is crucial for optimal infant nutrition.
Area of Science:
- Neonatal Nutrition
- Human Milk Fortification
- Preterm Infant Care
Background:
- Preterm infants require fortified human milk to meet nutrient needs.
- The impact of commercial fortifiers on donor milk composition is not well understood.
Purpose of the Study:
- To analyze how commercial fortifiers affect macronutrient and micronutrient levels in donor human milk.
- To compare nutrient intake from fortified donor milk with preterm infant recommendations.
Main Methods:
- Analyzed 400 donor milk samples for nutrient content.
- Calculated fortification and intake ratios for donor milk at 160 mL/kg/day.
- Compared nutrient levels to preterm infant intake recommendations.
Main Results:
- Fortifiers caused wide nutrient concentration ranges (75%-399% for macronutrients, 50%-800+% for vitamins/minerals).
- Unfortified milk met lower recommendations for lactose, fat, and pantothenic acid.
- Bovine and human-derived fortifiers showed specific nutrient shortfalls and excesses compared to recommendations.
Conclusions:
- Current US fortifiers often result in nutrient deficits and excesses when used with donor milk.
- Improved fortifier development based on donor milk nutritional values is needed for better preterm infant care.
