HM provided a clear protective effect against NEC , with an approximate 4 % reduction in incidence .
HM also provided a possible reduction in LOS , severe ROP and severe NEC .
Particularly for NEC , any volume of HM is better than EPTF , and the higher the dose the greater the protection .
Evidence regarding pasteurisation is inconclusive , but it appears to have no effect on some outcomes .
Improving the intake of mother ’s own milk ( MOM ) and /or donor HM results in small improvements in morbidity in this population
Randomized outcome trial of human milk fortification and developmental outcome in preterm infants.
Despite potential benefits , human milk may fail to meet preterm infants ' nutrient requirements . We tested the hypothesis that fortified breast milk , fed alone or with preterm formula , would improve neurodevelopment and growth at 18-mo follow-up without adverse short-term clinical or biochemical consequences . Two hundred seventy-five preterm infants from two medical centers ( birth weight < 1850 g ; mean gestation 29.8 + /- 2.7 wk ) whose mothers chose to provide breast milk were r and omly assigned to receive for a mean of 39 d a multinutrient fortifier or control supplement containing phosphate and vitamins . Breast milk comprised 47.6 % and 46.4 % of enteral intake in fortified and control groups , respectively ; preterm formula supplements were used when insufficient breast milk was available . Overall , there were no significant growth advantages with fortification ; although , when breast milk exceeded 50 % of intake , fortification promoted faster weight gain ( an advantage of 1.6 g.kg-1.d-1 ; 95 % CI : 0.1 , 3.1 ; P < 0.05 ) . Compared with control infants , the fortified group showed 1 ) higher plasma urea from week 2 ( P = 0.04 ) , 2 ) higher plasma calcium ( mean 2.34 + /- 0.01 compared with 2.27 + /- 0.02 mmol/L ; P = 0.003 ) , 3 ) a greater rise in alkaline phosphatase by week 6 ( P = 0.04 ) , 4 ) more clinical infections ( suspected plus proven ; 43 % compared with 31 % , P = 0.04 ) , 5 ) a nonsignificantly increased incidence of necrotizing enterocolitis ( 5.8 % compared with 2.2 % , P = 0.12 ) , and 6 ) higher white cell and platelet counts . Developmental scores at 18 mo were slightly but not significantly higher in the fortified group . This study confirmed that breast milk fortifiers can improve short-term growth ( when breast milk intakes are high ) ; but beneficial effects on long-term development remained unproven . Future research is required to evaluate potential adverse consequences and explore more optimal fortification strategies
HM provided a clear protective effect against NEC , with an approximate 4 % reduction in incidence .
HM also provided a possible reduction in LOS , severe ROP and severe NEC .
Particularly for NEC , any volume of HM is better than EPTF , and the higher the dose the greater the protection .
Evidence regarding pasteurisation is inconclusive , but it appears to have no effect on some outcomes .
Improving the intake of mother ’s own milk ( MOM ) and /or donor HM results in small improvements in morbidity in this population