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
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 standar...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/15/3/619 |
| _version_ | 1797623513587122176 |
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| author | Joanna Seliga-Siwecka Justyna Fiałkowska Anna Chmielewska |
| author_facet | Joanna Seliga-Siwecka Justyna Fiałkowska Anna Chmielewska |
| author_sort | Joanna Seliga-Siwecka |
| collection | DOAJ |
| description | 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, <i>p</i> = 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. |
| first_indexed | 2024-03-11T09:30:01Z |
| format | Article |
| id | doaj.art-089a1071cdc34770b3a7682c72b38d77 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-11T09:30:01Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-089a1071cdc34770b3a7682c72b38d772023-11-16T17:39:29ZengMDPI AGNutrients2072-66432023-01-0115361910.3390/nu15030619Effect of Targeted vs. Standard Fortification of Breast Milk on Growth and Development of Preterm Infants (≤32 Weeks): Results from an Interrupted Randomized Controlled TrialJoanna Seliga-Siwecka0Justyna Fiałkowska1Anna Chmielewska2Department of Neonatology and Neonatal Intensive Care, Medical University of Warsaw, 02–091 Warszawa, PolandDepartment of Neonatology and Neonatal Intensive Care, Medical University of Warsaw, 02–091 Warszawa, PolandDepartment of Clinical Sciences, Pediatrics, Umeå University, 901 87 Umeå, SwedenHuman 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, <i>p</i> = 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.https://www.mdpi.com/2072-6643/15/3/619breastmilkfortificationpreterm infanttargeted modificationneonatal intensive care unitmacronutrients |
| spellingShingle | Joanna Seliga-Siwecka Justyna Fiałkowska Anna Chmielewska 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 Nutrients breastmilk fortification preterm infant targeted modification neonatal intensive care unit macronutrients |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | breastmilk fortification preterm infant targeted modification neonatal intensive care unit macronutrients |
| url | https://www.mdpi.com/2072-6643/15/3/619 |
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