title: Growth and nutrient intakes of human milk-fed preterm infants provided with extra energy and nutrients after hospital discharge.
abstract: OBJECTIVE
  The purpose of this pilot study was to determine whether mixing a multinutrient fortifier to approximately one half of the human milk fed each day for a finite period after discharge improves the nutrient intake and growth of predominantly human milk-fed low birth weight infants. We also assessed the impact of this intervention on the exclusivity of human milk feeding.
  
  
  METHODS
  Human milk-fed (> or = 80% feeding per day) low birth weight (750-1800 g) infants (n = 39) were randomly assigned at hospital discharge to either a control or an intervention group. Infants in the control group were discharged from the hospital on unfortified human milk. Nutrient enrichment of human milk in the intervention group was achieved by mixing approximately one half of the human milk provided each day with a powdered multinutrient human milk fortifier for 12 weeks after discharge. Milk with added nutrients was estimated to contain approximately 80 kcal (336 kJ) and 2.2 g protein/100 mL plus other nutrients. Intensive lactation support was provided to both groups.
  
  
  RESULTS
  Infants in the intervention group were longer during the study period, and those born < or = 1250 g had larger head circumferences than infants in the control group. There was a trend toward infants in the intervention group to be heavier at the end of the intervention compared with those in the control group. Mean protein, zinc, calcium, phosphorus, and vitamins A and D intakes were higher in the intervention group.
  
  
  CONCLUSIONS
  Results from this study suggest that adding a multinutrient fortifier to approximately one half of the milk provided to predominantly human milk-fed infants for 12 weeks after hospital discharge may be an effective strategy in addressing early discharge nutrient deficits and poor growth without unduly influencing human milk feeding when intensive lactation support is provided.
authors.affiliation: Department of Clinical Dietetics, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8. deborah_l.o'connor@sickkids.ca
authors.forename: Deborah L
authors.initials: DL
authors.lastname: O'Connor
authors.forename: Sobia
authors.initials: S
authors.lastname: Khan
authors.forename: Karen
authors.initials: K
authors.lastname: Weishuhn
authors.forename: Jennifer
authors.initials: J
authors.lastname: Vaughan
authors.forename: Ann
authors.initials: A
authors.lastname: Jefferies
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Campbell
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Asztalos
authors.forename: Mark
authors.initials: M
authors.lastname: Feldman
authors.forename: Joanne
authors.initials: J
authors.lastname: Rovet
authors.forename: Carol
authors.initials: C
authors.lastname: Westall
authors.forename: Hilary
authors.initials: H
authors.lastname: Whyte
mesh_terms: D002657:Child Development / Q000502:physiology; D004734:Energy Metabolism; D005260:Female; D005500:Follow-Up Studies; D005527:Food, Fortified; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D008895:Milk, Human; D009751:Nutritional Requirements; D009753:Nutritive Value; D010351:Patient Discharge; D010865:Pilot Projects; D011336:Probability; D012016:Reference Values; D015430:Weight Gain