Early feeding of fortified breast milk and in-hospital-growth in very premature infants: a retrospective cohort analysis

BMC Pediatr. 2013 Nov 4;13:178. doi: 10.1186/1471-2431-13-178.


Background: Fortified human milk may not meet all nutritional needs of very preterm infants. Early transition from complementary parenteral nutrition to full enteral feeds might further impair in-hospital growth. We aimed to investigate the impact of the cumulative intake of fortified human milk on early postnatal growth in a cohort of very low birth weight infants after early transition to full enteral feeds.

Methods: Retrospective single-centre observational study. Data are presented as median (interquartile range).

Results: N = 206 very preterm infants were analysed (gestational age at birth 27.6 (25.6-29.6) weeks, birth weight 915 (668-1170) g). Full enteral feeds were established at postnatal day 8 (6-10) and adequate postnatal growth was achieved (difference in standard deviation score for weight from birth to discharge -0.105(-0.603 - -0.323)). Standard deviation score for weight from birth to day 28 decreased more in infants with a cumulative human milk intake > 75% of all enteral feeds (-0.64(-1.08 - -0.34)) compared to those with < 25% human milk intake (-0.41(-0.7 - -0.17); p = 0.017). At discharge, a trend towards poorer weight gain with higher proportions of human milk intake persisted. In contrast, we observed no significant difference for head circumference growth.

Conclusions: Our current standardized fortification of human milk may not adequately support early postnatal growth.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cephalometry
  • Child, Hospitalized
  • Cohort Studies
  • Energy Intake
  • Enteral Nutrition
  • Follow-Up Studies
  • Food, Fortified*
  • Germany
  • Gestational Age
  • Head / growth & development
  • Humans
  • Infant Food*
  • Infant Formula
  • Infant, Newborn
  • Infant, Premature / growth & development*
  • Infant, Very Low Birth Weight / growth & development*
  • Milk, Human*
  • Nutritional Requirements
  • Treatment Outcome
  • Weight Gain