Abstract
Objective
This study aimed to compare growth outcomes and tolerance among very low birth weight
(VLBW) infants receiving a new, liquid human milk fortifier (LHMF-NEW) or a human
milk fortifier-acidified liquid (HMF-AL).
Study Design
Retrospective, multicenter study of 515 VLBW infants in three regional neonatal intensive
care units. The primary objective was to compare growth velocity (g/kg/d) during fortification
between groups by repeated measures regression. Secondary outcomes of interest were
feeding tolerance and the incidence of late-onset sepsis, necrotizing enterocolitis,
and metabolic acidosis. Student's t, analysis of variance, Wilcoxon, and Kruskal–Wallis tests were used for numeric variables,
or chi-squared and Fisher's exact test for categorical variables.
Results
No demographic differences were identified between the groups (HMF-AL, n = 242; LHMF-NEW, n = 273). Growth velocity during fortification was significantly higher in the group
receiving LHMF-NEW, despite relatively similar total fluid, calorie, or protein intake
(p = 0.001). Feeding intolerance was comparable between fortifiers. Necrotizing enterocolitis
and late-onset sepsis did not differ between groups and metabolic acidosis was diagnosed
less frequently with the LHMF-NEW. Anthropometric measures at discharge and length
of stay were comparable.
Conclusion
Infants receiving human milk fortified with the LHMF-NEW had faster growth velocity
during fortification, similar tolerance, and less metabolic acidosis compared with
an earlier cohort of infants who received human milk fortified with an HMF-AL.
Key Points
-
Among VLBW infants, using an LHMF-NEW resulted in a faster growth velocity in weight
during several weeks of fortification than using the previous HMF-AL.
-
The incidence of feeding intolerance (stopping feeds >8 hour) in any given week of
fortification was low and not different between groups. Also, late-onset sepsis and
necrotizing enterocolitis were uncommon with no differences between groups, whereas
the incidence of metabolic acidosis was lower in infants receiving the LHMF-NEW.
-
No differences in length of stay or anthropometrics at discharge were identified.
Keywords
human milk fortification - human milk - growth velocity - postnatal nutrition - very
low birth weight infants
