Abstract
Objective. To evaluate the contribution of real-time human milk (HM) analysis in the development of individual fortification plans for very low birth weight (VLBW) infants (<1500 g). Methods. Pooled, 24-hour samples of HM were analyzed 1 to 2 times weekly. HM was fortified using 30 kcal/oz preterm formula (PTF) or acidified concentrated liquid formula (ACLF). Daily nutrient intakes, growth, and laboratory data were collected from the week prior to fortification and for the 4 weeks of the study period. Protein (g/kg/day) and energy (kcal/kg/day) intakes were calculated by adding the proportional contributions from HM and fortifier. Results. There were 24 VLBW infants. Both groups (PTF, n = 18; ACLF, n = 6) had similar birth characteristics. HM protein and energy content varied considerably throughout the study. Mean protein intake was significantly higher in infants receiving ACLF (P < 0.001) compared to PTF, while energy intake was similar. The proportion of HM used with ACLF was significantly higher than with PTF (P < 0.001). Mean blood urea nitrogen decreased by about half from prefortifier to week 1 in both groups, although levels were lower in PTF than ACLF infants. Conclusion. Real-time HM analysis and individualized fortification strategies are an effective means of improving protein and energy intakes in VLBW infants.
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