Abstract
The use of acidified milk for feeding infants has a long, interesting history that
appears to have developed from the use of buttermilk in Holland as early as the late
19th century for feeding infants with diarrhea. Physicians in the early 20th century
assumed that the observed benefits were from buttermilk's acidity leading to the practice
of acidifying infant formula. The historical and physiological perspective on the
use of acidified infant formula is now especially relevant with the emergence of an
acidified liquid human milk fortifier for preterm infants. Here, we review that history,
with a deeper dive into the contemporary research on the use of acidified human milk
fortifiers, the consequences for preterm infants, and the underlying physiological
mechanisms.
Key Points
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In the late 19th and early 20th century acidified feedings were in common use for
sick infants.
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By the mid-20th century, acidified feedings tested in preterm infants resulted in
acidic physiology and poor growth.
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The current practice of acidifying feedings in preterm infants has been associated
with metabolic acidosis, poor tolerance, and delayed growth.
Keywords
acidified feedings - human milk fortifier - infant formula - premature infant
