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Effect of targeted vs. standard fortification of breast milk on growth and development of preterm infants (≤32 weeks): results from an interrupted randomized controlled trial
Department of Neonatology and Neonatal Intensive Care, Medical University of Warsaw, Warszawa, Poland.
Department of Neonatology and Neonatal Intensive Care, Medical University of Warsaw, Warszawa, Poland.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
2023 (English)In: Nutrients, E-ISSN 2072-6643, Vol. 15, no 3Article in journal (Refereed) Published
Abstract [en]

Human milk is recommended for very low birth weight infants. Their nutritional needs are high, and the fortification of human milk is a standard procedure to optimize growth. Targeted fortification accounts for the variability in human milk composition. It has been a promising alternative to standard fixed-dose fortification, potentially improving short-term growth. In this trial, preterm infants (≤32 weeks of gestation) were randomized to receive human milk after standard fortification (HMF, Nutricia) or tailored fortification with modular components of proteins (Bebilon Bialko, Nutricia), carbohydrates (Polycal, Nutricia), and lipids (Calogen, Nutricia). The intervention started when preterms reached 80 mL/kg/day enteral feeds. Of the target number of 220 newborns, 39 were randomized. The trial was interrupted due to serious intolerance in five cases. There was no significant difference in velocity of weight gain during the supplementation period (primary outcome) in the tailored vs. standard fortification group: 27.01 ± 10.19 g/d vs. 25.84 ± 13.45 g/d, p = 0.0776. Length and head circumference were not significantly different between the groups. We found the feasibility of targeted fortification to be limited in neonatal intensive care unit practice. The trial was registered at clinicaltrials.gov NCT:03775785.

Place, publisher, year, edition, pages
MDPI, 2023. Vol. 15, no 3
Keywords [en]
breastmilk, fortification, macronutrients, neonatal intensive care unit, preterm infant, supplementation, targeted modification
National Category
Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:umu:diva-205017DOI: 10.3390/nu15030619ISI: 000930957100001PubMedID: 36771325Scopus ID: 2-s2.0-85147894716OAI: oai:DiVA.org:umu-205017DiVA, id: diva2:1738361
Available from: 2023-02-21 Created: 2023-02-21 Last updated: 2023-09-05Bibliographically approved

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Chmielewska, Anna

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