title: Human milk fortifier with high versus standard protein content for promoting growth of preterm infants: A meta-analysis.
abstract: OBJECTIVE
  To compare the growth of preterm infants fed standard protein-fortified human milk with that containing human milk fortifier (HMF) with a higher-than-standard protein content.
  
  
  METHODS
  Published articles reporting randomized controlled trials and prospective observational intervention studies listed on the PubMed®, Embase®, CINAHL and Cochrane Library databases were searched using the keywords 'fortifier', 'human milk', 'breastfeeding', 'breast milk' and 'human milk fortifier'. The mean difference with 95% confidence intervals was used to compare the effect of HMF with a higher-than-standard protein content on infant growth characteristics.
  
  
  RESULTS
  Five studies with 352 infants with birth weight ≤ 1750 g and a gestational age ≤ 34 weeks who were fed human milk were included in this meta-analysis. Infants in the experimental groups given human milk with higher-than-standard protein fortifier achieved significantly greater weight and length at the end of the study, and greater weight gain, length gain, and head circumference gain, compared with control groups fed human milk with the standard HMF.
  
  
  CONCLUSIONS
  HMF with a higher-than-standard protein content can improve preterm infant growth compared with standard HMF.
authors.affiliation: Department of Neonatology, The First Hospital of Jilin University, Changchun, Jilin Province, China.
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Liu
authors.affiliation: Department of Neonatology, The First Hospital of Jilin University, Changchun, Jilin Province, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Dang
authors.affiliation: Department of Neonatology, The First Hospital of Jilin University, Changchun, Jilin Province, China.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Lv
authors.affiliation: Department of Neonatology, The First Hospital of Jilin University, Changchun, Jilin Province, China.
authors.forename: Teng-Fei
authors.initials: TF
authors.lastname: Wang
authors.affiliation: Department of Neonatology, The First Hospital of Jilin University, Changchun, Jilin Province, China.
authors.forename: Jin-Feng
authors.initials: JF
authors.lastname: Du
authors.affiliation: Department of Neonatology, The First Hospital of Jilin University, Changchun, Jilin Province, China wuhui97@126.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Wu
mesh_terms: D061186:Breast Milk Expression; D004044:Dietary Proteins; D019587:Dietary Supplements; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008895:Milk, Human; D015430:Weight Gain
chemical_list: D004044:Dietary Proteins
keywords: Human milk; fortifier; growth; meta-analysis; preterm infants; protein