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CC BY 4.0 · Am J Perinatol
DOI: 10.1055/a-2527-4638
Original Article

Improved Growth Velocity Using a New Liquid Human Milk Fortifier in Very Low Birth Weight Infants: A Multicenter, Retrospective Study

Fernando Moya
1   Betty Cameron Children's Hospital and University of North Carolina Medical School, Wilmington, North Carolina
,
Jennifer Fowler
2   East Carolina University Health Medical Center, Greenville, North Carolina
,
Adrian Florens
3   Department of Neonatology, Kidz Medical Services, Palm Beach Children's Hospital, Palm Beach, Florida
,
Jennifer Dombrowski
3   Department of Neonatology, Kidz Medical Services, Palm Beach Children's Hospital, Palm Beach, Florida
,
Olivia Davis
3   Department of Neonatology, Kidz Medical Services, Palm Beach Children's Hospital, Palm Beach, Florida
,
Tiffony Blanks
1   Betty Cameron Children's Hospital and University of North Carolina Medical School, Wilmington, North Carolina
,
Austin Gratton
4   Novant Health New Hanover Regional Medical Center, Wilmington, North Carolina
› Institutsangaben Funding This retrospective study was supported by Research Grant 8716 from Mead Johnson Nutrition (MJN). The authors independently established the study design, conducted the collection and analysis of data, and made all final decisions to submit a manuscript for publication. MJN reviewed and provided comments on the final draft of the manuscript.
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Abstract

Objective

This study aimed to compare growth outcomes and tolerance among very low birth weight (VLBW) infants receiving a new, liquid human milk fortifier (LHMF-NEW) or a human milk fortifier-acidified liquid (HMF-AL).

Study Design

Retrospective, multicenter study of 515 VLBW infants in three regional neonatal intensive care units. The primary objective was to compare growth velocity (g/kg/d) during fortification between groups by repeated measures regression. Secondary outcomes of interest were feeding tolerance and the incidence of late-onset sepsis, necrotizing enterocolitis, and metabolic acidosis. Student's t, analysis of variance, Wilcoxon, and Kruskal–Wallis tests were used for numeric variables, or chi-squared and Fisher's exact test for categorical variables.

Results

No demographic differences were identified between the groups (HMF-AL, n = 242; LHMF-NEW, n = 273). Growth velocity during fortification was significantly higher in the group receiving LHMF-NEW, despite relatively similar total fluid, calorie, or protein intake (p = 0.001). Feeding intolerance was comparable between fortifiers. Necrotizing enterocolitis and late-onset sepsis did not differ between groups and metabolic acidosis was diagnosed less frequently with the LHMF-NEW. Anthropometric measures at discharge and length of stay were comparable.

Conclusion

Infants receiving human milk fortified with the LHMF-NEW had faster growth velocity during fortification, similar tolerance, and less metabolic acidosis compared with an earlier cohort of infants who received human milk fortified with an HMF-AL.

Key Points

  • Among VLBW infants, using an LHMF-NEW resulted in a faster growth velocity in weight during several weeks of fortification than using the previous HMF-AL.

  • The incidence of feeding intolerance (stopping feeds >8 hour) in any given week of fortification was low and not different between groups. Also, late-onset sepsis and necrotizing enterocolitis were uncommon with no differences between groups, whereas the incidence of metabolic acidosis was lower in infants receiving the LHMF-NEW.

  • No differences in length of stay or anthropometrics at discharge were identified.

Keywords

human milk fortification - human milk - growth velocity - postnatal nutrition - very low birth weight infants

Authors' Contributions

F.M. designed the study, analyzed the data, and helped to write the manuscript. J.F. collected the data and helped to write the manuscript. A.F. collected the data and helped to write the manuscript. J.D. collected the data and helped to write the manuscript. O.D. collected the data and helped to write the manuscript. T.F. collected the data and helped to write the manuscript. A.G. analyzed the data and helped to write the manuscript.


Supplementary Material



Publikationsverlauf

Eingereicht: 11. Juli 2024

Angenommen: 13. Januar 2025

Accepted Manuscript online:
29. Januar 2025

Artikel online veröffentlicht:
06. März 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
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