Fortified Human Milk for Very Low Birth Weight Infants: Correction of Mineral Inadequacies

Abstract

Very low birthweight (VLBW) infants fed human milk fortified with pasteurized, lyophilized skim and cream fractions of mature human milk developed signs of calcium and phosphorus inadequacy despite retentions of nitrogen and energy that were similar to intrauterine references. Sixteen VLBW infants were fed a revised preparation of fortified human milk (Group FM2, fresh mother’s milk plus human skim milk, calcium lactate, and mono- and dibasic phosphates) and compared to 10 similar infants fed cow milk-based formula (Group CM). Birthweight and gestation were similar (<1.35 kg and 30 weeks, respectively). Both groups received similar intakes (per kg/d) of N (479 mg), energy (129 kcal), and P (69 mg); Ca intake was greater in group CM (144 vs 128 mg). Ninety-six hour balance studies were performed at 25 (B1) and 38 (B2) days of age. N retention, 330 vs 317 mg/kg/d, and metabolizable E, 106 vs 108 kcal/kg/d were similar between groups, FM and CM, respectively. Despite greater intakes of calcium in CM and similar intakes of P in both groups, absorption and retention of Ca and P were greater in FM2.