Growth and body composition of human milk-fed premature infants provided with extra energy and nutrients early after hospital discharge: 1-year follow-up

J Pediatr Gastroenterol Nutr. 2009 Oct;49(4):456-66. doi: 10.1097/MPG.0b013e31819bc94b.


Objectives: Human milk (HM) is the optimal source of nutrition for premature infants; however, it is unclear whether HM alone is sufficient to meet their elevated nutritional requirements early after hospital discharge. We previously reported that premature infants (750-1800 g birth weight) fed HM containing extra nutrients for 12 weeks after discharge had dietary intakes closer to recommended levels and grew more rapidly than those fed HM alone. The objectives of the present article are to examine the impact of this intervention on bone mineralization, body composition, and HM use up to 1 year. Data are also presented on general developmental level at 18-month corrected age (CA).

Patients and methods: At discharge, predominantly HM-fed infants were randomized to receive for 12 weeks either approximately half of their feedings containing a multinutrient fortifier (intervention, n=19) or all of their feedings as HM alone (control, n=20).

Results: Intervention infants remained longer (P<0.001) and had greater whole-body bone mineral content (P=0.02) until 12-month CA compared with controls. Intervention infants born less than or equal to 1250 g continued to have a larger mean head circumference throughout the first year of life (P<0.0001). Human milk feeding ( differed between groups at 6- (P=0.035), but not 12-month CA. No statistically significant differences were found between groups in the mental, motor, or behavior rating scale scores of the Bayley II at 18-month CA.

Conclusions: Adding a multinutrient fortifier to HM provided to predominantly HM-fed premature infants early after discharge results in sustained differences in weight, length, and whole-body bone mineral content, and in smaller babies, head circumference for the first year of life.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Composition*
  • Body Size
  • Bone Density
  • Diet*
  • Dietary Supplements*
  • Energy Intake
  • Follow-Up Studies
  • Head / anatomy & histology
  • Humans
  • Infant
  • Infant Formula / chemistry
  • Infant Nutritional Physiological Phenomena*
  • Infant, Newborn
  • Infant, Premature / growth & development*
  • Infant, Small for Gestational Age / growth & development
  • Intention to Treat Analysis
  • Milk, Human*
  • Patient Discharge
  • Treatment Outcome