Jump to navigation. Review question: Does feeding preterm infants with breast milk fortified with extra nutrients including protein and energy compared with unfortified breast milk increase growth rate and improve development? Background: Breast milk alone may not provide preterm infants with sufficient quantities of nutrients to support optimal growth and development.
Evidence indicates that human milk HM is the best form of nutrition uniquely suited not only to term but also to preterm infants conferring health benefits in both the short and long-term. However, HM does not provide sufficient nutrition for the very low birth weight VLBW infant when fed at the usual feeding volumes leading to slow growth with the risk of neurocognitive impairment and other poor health outcomes such as retinopathy and bronchopulmonary dysplasia. HM should be supplemented fortified with the nutrients in short supply, particularly with protein, calcium, and phosphate to meet the high requirements of this group of babies.
Providing very-low-birthweight babies with fortified human donor breast milk made no difference to their developmental neurological outcomes at 18 months compared with giving formula. This randomised controlled trial looked at babies with birth weights of less than g in neonatal intensive care units in Canada. There was no difference in their understanding, language, or ability to manipulate objects at 18 months.
Human milk is the ideal feeding for all infants. While the nutrient composition of human milk is ideal for term infants; protein and mineral content of human milk is insufficient to meet the needs of the growing preterm infant. As the mineral content of TPN is limited, preterm infants will accrue a mineral deficit until fortification of human milk is initiated.
However, breast milk's nutrient content is not sufficient for preterm infants, and interindividual variation is high. The variation challenges standard fortification, which assumes a standard breast milk composition. Two new fortification strategies adjustable fortification and target fortification optimize macronutrient intake and improve growth.
Normal breast milk or formula usually has 20 calories per ounce. Most babies do well on regular breast milk or formula. Your baby may need high calorie breast milk or formula if she is smaller than normal or gains less weight than expected.
This document has been produced by the World Health Organization. It is a summary of findings and some data from the systematic review may therefore not be included. Please refer to the original publication for a complete review of findings.
About one in eight babies in the U. Centers for Disease Control and Prevention. Godswill Keraoru is one of those babies. Extremely premature infants, born before 30 weeks of pregnancy, have small stomachs, and have a hard time consuming enough milk.
NOTE: We review our guidelines regularly and this guideline is now past its review date. The content of the guideline below may not reflect the most recent evidence based practice. Please use with caution.