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Comment published on 16 December 2016, see Nutrients 2016, 8(12), 821.

Open AccessArticle
Nutrients 2016, 8(8), 451; doi:10.3390/nu8080451

Comparison of a Powdered, Acidified Liquid, and Non-Acidified Liquid Human Milk Fortifier on Clinical Outcomes in Premature Infants

1
Newborn Intensive Care Unit, Nebraska Medicine, 981200 Nebraska Medical Center, Omaha, NE 68198, USA
2
College of Public Health, University of Nebraska Medical Center, 984375 Nebraska Medical Center, Omaha, NE 68198-4375, USA
3
Department of Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE 68198-1205, USA
*
Author to whom correspondence should be addressed.
Received: 20 May 2016 / Revised: 14 July 2016 / Accepted: 18 July 2016 / Published: 26 July 2016
(This article belongs to the Special Issue Nutrients in Infancy)
View Full-Text   |   Download PDF [215 KB, uploaded 26 July 2016]

Abstract

We previously compared infant outcomes between a powdered human milk fortifier (P-HMF) vs. acidified liquid HMF (AL-HMF). A non-acidified liquid HMF (NAL-HMF) is now commercially available. The purpose of this study is to compare growth and outcomes of premature infants receiving P-HMF, AL-HMF or NAL-HMF. An Institutional Review Board (IRB) approved retrospective chart review compared infant outcomes (born < 2000 g) who received one of three HMF. Growth, enteral nutrition, laboratory and demographic data were compared. 120 infants were included (P-HMF = 46, AL-HMF = 23, NAL-HMF = 51). AL-HMF infants grew slower in g/day (median 23.66 vs. P-HMF 31.27, NAL-HMF 31.74 (p < 0.05)) and in g/kg/day, median 10.59 vs. 15.37, 14.03 (p < 0.0001). AL-HMF vs. NAL-HMF infants were smaller at 36 weeks gestational age (median 2046 vs. 2404 g, p < 0.05). However AL-HMF infants received more daily calories (p = 0.21) and protein (p < 0.0001), mean 129 cal/kg, 4.2 g protein/kg vs. P-HMF 117 cal/kg, 3.7 g protein/kg , NAL-HMF 120 cal/kg, 4.0 g protein/kg. AL-HMF infants exhibited lower carbon dioxide levels after day of life 14 and 30 (p < 0.0001, p = 0.0038). Three AL-HMF infants (13%) developed necrotizing enterocolitis (NEC) vs. no infants in the remaining groups (p = 0.0056). A NAL-HMF is the most optimal choice for premature human milk-fed infants in a high acuity neonatal intensive care unit (NICU). View Full-Text
Keywords: human milk; fortifier; premature infant; enteral nutrition; growth; acidosis; necrotizing enterocolitis human milk; fortifier; premature infant; enteral nutrition; growth; acidosis; necrotizing enterocolitis
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Thoene, M.; Lyden, E.; Weishaar, K.; Elliott, E.; Wu, R.; White, K.; Timm, H.; Anderson-Berry, A. Comparison of a Powdered, Acidified Liquid, and Non-Acidified Liquid Human Milk Fortifier on Clinical Outcomes in Premature Infants. Nutrients 2016, 8, 451.

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