Comparative growth outcomes in very low birth weight preterm infants fed an exclusive human milk diet versus bovine milk-based fortification
Keywords:
exclusive human milk diet, bovine milk based fortifier, preterm infant growthAbstract
Background and aim: Human milk feeding in preterm infants reduces the risk of several neonatal morbidities. However, human milk does not provide sufficient macro- and micronutrients to meet the nutritional requirements of preterm infants. Evidence indicates that, compared with the use of bovine milk-based fortifiers (BMFs), human milk-based fortifiers (HMFs) are associated with a reduced incidence of necrotizing enterocolitis, late-onset sepsis, and mortality, as well as improved feeding tolerance and neurodevelopmental outcomes. Nonetheless, few studies have addressed growth in preterm infants fed an exclusive human milk diet. This study aimed to compare growth rates in very low birth weight (VLBW) infants receiving human milk fortified with an HMF or a BMF.
Methods: This retrospective cohort analysis included preterm infants born with a birth weight ≤1,500 g between January 1, 2021, and December 31, 2024, and admitted to the neonatal intensive care unit. Infants received human milk fortified with either an HMF or a BMF according to standard protocols. The primary outcomes were weight, head circumference, and length growth velocities.
Results: No significant differences in weight, head circumference, or length growth velocities were observed between the two groups until discharge. However, weight growth velocity until fortifier discontinuation was significantly lower in the HMF group. Since the duration of fortification varied, assessing growth velocity from birth to discharge may be more clinically meaningful.
Conclusions: Overall growth from birth to discharge is comparable between HMFs and BMFs in VLBW infants, although early weight gain is reduced with HMFs.
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