Clinical and nutritional outcomes of two liquid human milk fortifiers for premature infants

Article type: Research Article

Authors: Lainwala, Shabnam^{a; b; *} | Kosyakova, Natalia^c | Spizzoucco, Ann Marie^d | Herson, Victor^{a; b} | Brownell, Elizabeth A.^{a; b}

Affiliations: [a] Division of Neonatology, Connecticut Children’s Medical Center, Hartford, CT, USA | [b] Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA | [c] University of Connecticut, Storrs, CT, USA | [d] Department of Nutrition, Connecticut Children’s Medical Center, Hartford, CT, USA

Correspondence: [*] Address for correspondence: Shabnam Lainwala, MBBS, PHD, Division of Neonatology, Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT 06106. Tel.: +1 860 545 8950; Fax: +1 860 545 8959; E-mail: slainwala@connecticutchildrens.org.

Abstract: BACKGROUND:In preterm infants fortification of human milk with human milk fortifiers (HMF) to optimize nutrition and growth is standard practice. We compared clinical, nutrition and growth outcomes in infants receiving two types of liquid HMF (LHMF). METHODS:Clinical, nutrition and growth outcomes were compared between infants admitted to a level IV NICU, and born with birth weight less than or equal to 1800 grams, between 10/1/2014-12/31/2014 and received human milk with acidified LHMF (ALHMF) and between 1/1/2015-4/31/2015 and received human milk with heat treated LHMF (HTLHMF). RESULTS:Of the 85 qualifying infants, 67 received human milk and LHMF. ALHMF group had significantly higher incidence of metabolic acidosis and lower bicarbonate and base excess levels relative to infants receiving HTLHMF (P < 0.001). There were no significant differences by LHMF status in other clinical outcomes and nutrition and growth outcomes. In multivariate analyses, ALHMF use was associated with metabolic acidosis, and lower base excess and bicarbonate levels. CONCLUSION:In our study, the clinical, nutrition and growth outcomes between the two LHMF groups were similar. However, use of ALHMF in preterm infants was associated with increased incidence of metabolic acidosis in our cohort. Further randomized control trials are warranted to evaluate these findings.

Keywords: Premature, feeding, human milk fortifier, metabolic acidosis, preterm, nutrition

DOI: 10.3233/NPM-16164

Journal: Journal of Neonatal-Perinatal Medicine, vol. 10, no. 4, pp. 393-401, 2017