Use of human milk fortifier in preterm infants in the community: practical experience from clinical cases

Delsoglio, Marta, Russo, Isabella, Capener, Rebecca, Claire, Samantha, Clarke, Paul ORCID: https://orcid.org/0000-0001-6203-7632, Norris, Heather, Stratton, Rebecca J. and Hubbard, Gary P. (2024) Use of human milk fortifier in preterm infants in the community: practical experience from clinical cases. HSOA Journal of Neonatology and Clinical Pediatrics, 11 (3). ISSN 2378-878X

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Abstract

Introduction: Breast milk supplementation with a multicomponent Human Milk Fortifier (HMF) has been shown to be safe and effective in preterm infants in neonatal units, while there is little clinical evidence on its use post-discharge. This series of case-studies aimed to investigate practical use and experience of HMF supplementation in preterm infants with different conditions in the community. Methods: Preterm infants experiencing faltering growth were recruited from two UK neonatal units and supplemented with a novel HMF containing long-chain polyunsaturated fatty acids, medium-chain fatty acids, and anhydrous milk fat as source of beta-palmitate for >7 days in the community. Compliance with prescription, anthropometrics and growth, gastrointestinal (GI) tolerance, acceptability and safety were recorded at baseline, on day of hospital discharge and at the end of intervention. Results: Fourteen infants (mean age: 35weeks+4days (SD 2w+5d) were supplemented with HMF for 29days (SD2, range 15-55) in the community (mean intake 6.2g/d (SD2.6), 26.8kcal/d (SD11.4)), with n=12 being initiated in hospital (mean duration of supplementation=12days (SD11), range 0-37), n=1 on day of discharge and n=1 in the community. Mean compliance was 96% (SD13), with n=13 consuming 100% of HMF prescribed by their healthcare professional (HCP). Infants showed an increase in mean weight (+1.14kg SD0.58), length (+6.66cm SD3.91) and head circumference (+4.35cm SD2.86), with improvement in weight-for-age and length-for-age Z-scores compared to baseline. Mean growth velocity during the intervention period was 15.7g/kg/day (SD 8.62), being 18.0g/kg/day (SD 13) during hospital stay and 10.6g/kg/day (SD 4.4) in the community. Twelve infants (86%) met their growth goal at the end of intervention. There were no GI concerns with the use of HMF, with n=3 experiencing no GI symptoms and n=11 experiencing a few minor symptoms. Most parents (79%) found HMF easy to use and were satisfied overall. Conclusion: The novel HMF supported infants’ growth both during hospital stay and, in the community, whilst being well complied with and accepted overall. No tolerance concerns were reported in this study population. Clear guidelines and standardised protocol on how to use HMF post-discharge are needed.

Item Type:	Article
Uncontrolled Keywords:	sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	LivePure Connector
Date Deposited:	12 Jul 2024 08:31
Last Modified:	25 Sep 2024 17:55
URI:	https://ueaeprints.uea.ac.uk/id/eprint/95888
DOI:	10.24966/NCP-878X/100128

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