Extrauterine Growth Restriction: What Is the Evidence for Better Nutritional Practices in the Neonatal Intensive Care Unit?

Dana Lunde, DNP RNC APRN NNP-BC

Disclosures

NAINR. 2014;14(3):92-98. 

In This Article

Human Milk Based Human Milk Fortifier

Human milk based human milk fortifiers allow the premature infant to receive an exclusive human milk diet throughout their hospital stay, which was shown to decrease the incidence of NEC by 50%.[33] Chan and colleagues[49] conducted a human milk analysis to compare the effects of a human milk based human milk fortifier on the antibacterial activity of human milk. Human milk samples were taken during the first week of life from 10 lactating mothers. The effects of both standard powdered human milk fortifier and the new human milk based human milk fortifier antimicrobial activity was evaluated using the filter paper method and the growth inhibition method. Each milk specimen was exposed to Enterobacter sakazakii, E. Coli, C. difficile and Shigella. Human milk alone inhibited the growth of all the bacterial organisms while the addition of the standard powdered human milk fortifier almost completely inhibited the antibacterial activity of human milk alone. The addition of the human milk based human milk fortifier did not have an effect on the antibacterial activity of the human milk.

Human milk based human milk fortifier is another option available to fortify human milk to meet the needs of the premature infant. The evidence supports the use of a human milk based human milk fortifier to provide an exclusive human milk diet, which decreases the incidence of NEC. In comparison to the standard powdered human milk fortifier, a human milk based human milk fortifier further enhances the antibacterial activity of human milk.

Today many options for human milk fortification exist all of which are supported by strong evidence. As the science of human milk fortification continues to evolve, the need for individualized human milk fortification is becoming apparent. Although early evidence[50,51] are showing promising results and individualizing human milk fortification makes clinical sense, further research is warranted.

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