Review of the most contentious issues of breast milk fortification in preterm infants

AbstractThe introduction and use of breast milk enrichment techniques in the practice of a neonatologist is one of the main aspects of successful nursing of deeply premature infants. Currently, the subject of discussion is which method of fortification is the most effective and safe, whether there is a need to enrich breast milk after discharge of a premature baby and what to do in case of postnatal growth disorder in a premature baby receiving a nutrient subsidy by the standard method of enrichment. These issues are the subject of discussion of the presented review.

Keywords:postnatal growth disorder, breast milk, fortification, premature infants

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Grosheva E.V., Zubkov V.V. Review of the most contentious issues of breast milk fortification in preterm infants. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2021; 9 (4): 49-57. DOI: https://doi.org/10.33029/2308-2402-2021-9-4-49-57 (in Russian)

REFERENCES

1. Silveiraa R.C., Soibelmann Procianoy R. Preterm newborn’s postnatal growth patterns: how to evaluate them. J Pediatr. 2019; 95 (suppl 1): 42-8.

2. Horbar J.D., Ehrenkranz R.A., Badger G.J., Edwards E.M., Morrow K.A., Soll R.F., et al. Weight growth velocity and postnatal growth failure in infants 501 to 1500 grams: 2000-2013. Pediatrics. 2015; 136 (1): e84-92.

3. Hossain Z., Qasem W.A., Friel J.K., Omri A. Effects of total enteral nutrition on early growth, immunity and neuronal development of preterm infants. Nutrients. 2021; 13 (8): 2755.

4. Schanler R.J., Garza C., Nichols B.L. Fortified mothers’ milk for very low birth weight infants: results of growth and nutrient balance studies. J Pediatr. 1985; 107 (3): 437-45.

5. Ziegler E.E. Human milk and human milk fortifiers. World Rev Nutr Diet. 2014; 110: 215-27.

6. Billeaud C., Boue-Vaysse C., Couedelo L., Steenhout P., Jaeger J., Cruz-Hernandez C., et al. Effects on fatty acid metabolism of a new powdered human milk fortifier containing medium-chain triacylglycerols and docosahexaenoic acid in preterm infants. Nutrients. 2018; 10: E690.

7. Billeaud C., Boue-Vaysse C., Couedelo L., Steenhout P., Jaeger J., Cruz-Hernandez C., et al. Correction: Billeaud et al. "Effects on Fatty Acid Metabolism of a New Powdered Human Milk Fortifier Containing Medium-Chain Triacylglycerols and Docosahexaenoic Acid in Preterm Infants". Nutrients. 2018, 10, 690. Nutrients. 2019; 11 (3): 680.

8. Rigo J., Hascoet J.M., Billeaud C., Picaud J.C., Mosca F., Rubio A., et al. Growth and nutritional biomarkers of preterm infants fed a new powdered human milk fortifier: a randomized trial. J Pediatr Gastroenterol Nutr. 2017; 65: e83-93.

9. Grosheva E.V., Lavrova T.E., Talyzina M.F., Zubkov V.V. The osmolality of enteral feeding for preterm infants: from myths toward evidence-based medicine. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2018; 6 (4): 63-9. (in Russian)

10. American Academy of Pediatrics. Commentary on breast-feeding and infant formulas, including proposed standards for formulas. Pediatrics. 1976; 57: 278-85.

11. Santulli T.V., et al. Acute necrotizing enterocolitis in infancy: a review of 64 cases. Pediatrics. 1975; 55 (3): 376-87.

12. Book L.S., et al. Necrotizing enterocolitis in low-birthweight infants fed an elemental formula. J Pediatr. 1975; 87: 602-5.

13. Grosheva E.V. Optimizing nutritional support in extremely low and very low birth weight children: Autoabstract of Diss. Moscow, 2013. (in Russian)

14. Janjindamai W., et al. Effect of fortification on the osmolality of human milk. J Med Assoc Thai. 2006; 89: 1400-3.

15. Kanmaz H.G., et al. Human milk fortification with differing amounts of fortifier and its association with growth and metabolic responses in preterm infants. J Hum Lact. 2013; 29 (3): 400-5.

16. Kim J.H., Chan G., Schanler R., Groh-Wargo S., et al. Growth and tolerance of preterm infants fed a new extensively hydrolyzed liquid human milk fortifier. J Pediatr Gastroenterol Nutr. 2015; 61 (6): 665-71.

17. Singh P., et al. Comparison of osmolality of human milk after fortification with three different fortifiers. Curr Med Res Pract. 2017; 7: 81-3.

18. Rochow N., Fusch G., Ali A., et al. Individualized target fortification of breast milk with protein, carbohydrates, and fat for preterm infants: a double-blind randomized controlled trial. Clin Nutr. 2021; 40: 54-63.

19. Brown J.V.E., Embleton N.D., Harding J.E., McGuire W. Muitinutrient fortification of human milk for preterm infants. Cochrane Database Syst Rev. 2016; 5: CD000343.

20. Rochow N., Fusch G., Choi A., Chessell L., Elliott L., McDonald K., et al. Target fortification of breast milk with fat, protein, and carbohydrates for preterm infants. J Pediatr. 2013; 163 (4): 1001-7.

21. De Curtis M., et al. Effect of fortification on the osmolality of human milk. Arch Dis Child Fetal Neonatal Ed. 1999; 81: F141-3.

22. Koo W., Tice H. Human milk fortifiers do not meet the current recommendation for nutrients in very low birth weight infants. JPEN J Parenter Enteral Nutr. 2018; 42: 813-20.

23. Pearson F., Johnson M.J., Leaf A.A. Milk osmolality: does it matter? Arch Dis Child Fetal Neonatal Ed. 2013; 98: F166-9.

24. Kreissl A., Zwiauer V., Repa A., Binder C., Haninger N., Jilma B., et al. Effect of fortifiers and additional protein on the osmolarity of human milk: is it still safe for the premature infant? J Pediatr Gastroenterol Nutr. 2013; 57: 432-7.

25. Rosas R., Sanz M.P., Fernandez-Calle P, Alcaide M.J., Montes M.T., Pastrana N., et al. Experimental study showed that adding fortifier and extra-hydrolysed proteins to preterm infant mothers’ milk increased osmolality. Acta Paediatr. 2016; 105: e555-60.

26. Janjindamai W., et al. Effect of fortification on the osmolality of human milk. J Med Assoc Thai. 2006; 89: 1400-3.

27. Kreins N., Buffin R., Michel-Molnar D., Chambon V., Pradat P., Picaud J. Individualized fortification influences the osmolality of human milk. Front Pediatr. 2018; 6: 322.

28. Bartowska J., Szwajkowska M., Litwin’czuk Z., et al. Nutritional value and technological suitability of milk from various animal species used for dairy production. Compr Rev Food Sci Food Saf. 2011; 10: 291-302.

29. Lionetti L., Cavaliere G., Bergamo P., et al. Diet supplementation with donkey milk upregulates liver mitochondrial uncoupling, reduces energy efficiency and improves antioxidant and antiinflammatory defences in rats. Mol Nutr Food Res. 2012; 56: 1596-600.

30. Trinchese G., Cavaliere G., Canani R.B., et al. Human, donkey and cow milk differently affects energy efficiency and inflammatory state by modulating mitochondrial function and gut microbiota. J Nutr Biochem. 2015; 26: 1136-46.

31. Cresi F., Maggiora E., Pirra A., Tonetto P., Rubino C., Cavallarin L., et al. Effects on gastroesophageal reflux of donkey milk-derived human milk fortifier versus standard fortifier in preterm newborns: additional data from the Fortilat study. Nutrients. 2020; 12 (7): 2142.

32. Bertino E., Cavallarin L., Cresi F., Tonetto P., Peila C., Ansaldi G., et al. A novel donkey milk-derived human milk fortifier in feeding preterm infants: a randomized controlled trial. J Pediatr Gastroenterol Nutr. 2019; 68 (1): 116-23.

33. O’Connor D.L., Kiss A., Tomlinson C., Bando N., Bayliss A., et al. OptiMoM feeding group. Nutrient enrichment of human milk with human and bovine milk-based fortifiers for infants born weighing <1250 g: a randomized clinical trial. Am J Clin Nutr. 2018; 108: 108-16.

34. Arslanoglu S., Moro G.E., Ziegler E.E.; and the WAPM Working Group on Nutrition. Optimization of human milk fortification for preterm infants: new concepts and recommendations. J Perinat Med. 2010; 38: 233-8.

35. Arslanoglu S. IV. Individualized fortification of human milk: adjustable fortification. J Pediatr Gastroenterol Nutr. 2015; 61 (suppl 1): S4-5.

36. Arslanoglu S., Boquien C.-Y., King C., Lamireau D., Tonetto P., Barnett D., et al. Fortification of human milk for preterm infants: update and recommendations of the European Milk Bank Association (EMBA) Working Group on Human Milk Fortification. Front Pediatr. 2019; 7: 76.

37. Fabrizio V., Trzaski J.M., Brownell E.A., Esposito P., Lainwala S., Lussier M.M., et al. Individualized versus standard diet fortification for growth and development in preterm infants receiving human milk. Cochrane Database Syst Rev. 2020; 11: CD013465.

38. Arslanoglu S., Moro G.E., Ziegler E.E. Adjustable fortification of human milk fed to preterm infants: does it make a difference? J Perinatol. 2006; 26: 614-21.

39. Moro G.E., Minoli I., Ostrom M., Jacobs J.R., Picone T.A., Raiha N.C.R., et al. Fortification of human milk: evaluation of a novel fortification scheme and of a new fortifier. J Pediatr Gastroenterol. 1995; 20: 162-72.

40. Arslanoglu S., Bertino E., Coscia A., Tonetto P., Giuliani F., Moro G.E. Update of adjustable fortification regimen for preterm infants: a new protocol. J Biol Regul Homeost Agents. 2012; 26 (3 Suppl): 65-7.

41. Boehm G., Muller D., Beyreiss K., Raiha N. Evidence for functional immaturity of the ornithine-urea cycle in very-low-birth-weight infants. Biol Neonate. 1988; 54 (3): 121-5.

42. Picaud J., Houeto N., Buffin R., Loys C., Godbert I., Hays S. Additional protein fortification is necessary in extremely low-birth-weight infants fed human milk. J Pediatr Gastroenterol Nutr. 2016; 63 (1): 103-5.

43. Gates A., Marin T., Leo G., Stansfield B.K. Review of preterm human-milk nutrient composition. Nutr Clin Pract. 2020; Aug 30.

44. Grosheva E.V., Baibarina E.N., Degtyarev D.N., Lenyushkina A.A., Antonov A.G., Ryumina 1.1., et al. Optimization of enteral feeding in extremely premature neonatal infants in the hospital setting. Akusherstvo i ginekologiya [Obstetrics and Gynecology]. 2012; (2): 57-61. (in Russian)

45. Abiramalatha T., Thomas N., Thanigainathan S. High versus standard volume enteral feeds to promote growth in preterm or low birth weight infants. Cochrane Database Syst Rev. 2021; 3 (3): CD012413.

46. Aggett P.J., Agostoni C., Axelsson I., De Curtis M., Goulet O., Hernell O., et al. Feeding preterm infants after hospital discharge: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2006; 42: 596-603.

47. Ribas S.A., Cunha D.B., Paravidino V.B., et al. Protein and energy intake and nutritional evolution of preterm infants after hospital discharge: a longitudinal study. Early Hum Dev. 2020; 149: 105136.

48. Embleton N.D., Wood C.L., Pearce M.S., et al. Early diet in preterm infants and later cognition: 10-year follow-up of a randomized controlled trial. Pediatr Res. 2021; 89 (6): 1442-6.

49. O’Connor D.L., Khan S., Weishuhn K., Vaughan J., Jefferies A., Campbell D.M., et al. Growth and nutrient intakes of human milk-fed preterm infants provided with extra energy and nutrients after hospital discharge. Pediatrics. 2008; 121: 766-76.

50. Aimone A., Rovet J., Ward W., Jefferies A., Campbell D.M., Asztalos E., et al. Growth and body composition of human milk-fed premature infants provided with extra energy and nutrients early after hospital discharge: 1-year follow-up. J Pediatr Gastroenterol Nutr. 2009; 49: 456-66.

51. Grosheva E.V., Degtyareva A.V., Ionov O.V., Lenyushkina A.A., et al. Enteral feeding of premature babies. In: Selected clinical guidelines for neonatology. Eds. by E.N. Baibarina, D.N. Degtyarev. Moscow : GEOTAR-Media, 2016; Ch 5: 103-25. (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Degtyarev Dmitriy Nikolaevich
Doctor of Medical Sciences, Professor, Deputy Director for Scientific Research of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Head of the Chair of Neonatology at the Clinical Institute of Children's Health named after N.F. Filatov, I.M. Sechenov First Moscow State Medical University, Chairman of the Ethics Committee of the Russian Society of Neonatologists, Moscow, Russian Federation

ORCID iD 0000-0001-8975-2425

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