Claudia writes:
"We have a neo that has told a mom that she needs to supplement her twins
with
expressed breastmilk plus powdered human milk fortifier for the next 4-6
months. Baby's were born at 30 weeks, were healthy, never on a vent, and
went home 2 weeks ago at appx 36 weeks adjusted gestational age. Has anyone
heard of giving the fortifier for this long?"
I went to the Central New York Breastfeeding Connection conference in
Syracuse, New York yesterday. The subject of the day was BF the premature
baby. Kathleen Marinelli, MD (neonatalogist) and Mary Lussiere, RN, IBCLC,
from Connecticut Children's Medical Center, presented.
From this presentation I learned that, although human milk fortifiers
increase calories somewhat, the main reason for using them is to increase
protien, calcium and phosphorus levels in the milk to meet the special needs
of premature babies. This is to approximate the rate of growth in utero.
Once the baby is ready for discharge, he/she is close to or at 40 weeks
corrected gestational age and fortifiers are not used because nutritional
needs are different.
These items were included in the bibliography. I don't know what
information the articles, but maybe something here will be the reference you
need:
Barb Berges BS, RN, IBCLC
Rochester, New York
Abrams SA, Schanler RJ, Tsang RC, Garza C. Bone mineralization in former
very low birth weight infants fed either human milk or commercial formula:
one year follow-up observation. J Peds 1989; 1041-1044.
Barrett Reis B, Hall RT, Schanler RJ, et al. Enhanced growth of preterm
infants fed a new powdered human milk fortifier: a randomized controlled
trial. Pediatrics 2000; 106: 581-588.
Hall RT, Wheeler RE, Rippetoe LE. Calcium and phosphorous supplementation
after initial hospital discharge in breast-fed infants of less than 1800
grams birth weight. J Periinatol 1993; XIII: 272-278.
Lucas A, Fewtrell MS, Morely R, et al. Randomized outcome trial of human
milk fortification and developmental outcome in preterm infants. Am J Clin
Nut 1996; 64: 142-51.
Raiha NC. Human milk feedings for premature infants: a historical
perspective. In Human Milk for Very-Low-Birth-Weight Infants. Report of
the 108th Ross Conference in Pediatric Research. Columbus, Ohio, 1999,
1-15.
Schanler RJ, Abrams, SA. Postnatal attainment of intrauterine macromineral
accretion rates in low birth weight infants fed fortified human milk. J
Pediatr 1995; 126: 441-447.
Schanler RJ, Henderson TR, Hamosh M. Fatty acid soaps may be responsible
for poor fat absorption in premature infants fed fortified human milk.
Pediatr Res 1999; 45: 290A.
Schanler RJ, Shulman RJ, Lau C. Feeding strategies for premature infants:
beneficial outcomes of feeding fortified human milk versus preterm formula.
Pediatrics 1999; 103: 1150-1157.
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