Targeted fortification of maternal breast milk to prevent postnatal growth failure in preterm infants : A randomised control trial

Human breast milk is considered an ideal type of enteral nutrition among preterm neonates as the available evidence indicates both short-term and long-term benefits. However, for preterm infants, the amount of calories, macronutrients, electrolytes, minerals, and micronutrients provided by human breast milk (either maternal or donor breast milk) is insufficient to support and ensure appropriate postnatal growth that is on par with intra-uterine growth. Consequently, fortification of human breast milk with commercially available standard human milk fortifier is being undertaken to meet the deficit nutritional needs. Nevertheless, a significant proportion of preterm infants still do not achieve recommended postnatal growth velocity due to macronutrients and calorie insufficiency because of varied breast milk composition across the maternal population. Targeted fortification of maternal breast milk facilitates the optimization of of enteral nutritional intake through the measurement of the macronutrient and calorie content of native breast milk, adding standard human milk fortifier, and individually adjusting calorie, protein, and fat content with protein and fat human milk additives to reach ESPGHAN recommended daily requirements. Thus, the process may improve the postnatal growth velocity, facilitate proportionate growth, and minimize postnatal growth failure among preterm infants.