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Growth and clinical efficacy of fortified human milk and premature formula on very low birth weight infants

Korean Journal of Pediatrics 2008;51(7):704-712.
Published online July 15, 2008.
Growth and clinical efficacy of fortified human milk and premature formula on very low birth weight infants
Heewon Chueh1, Myo Jing Kim1, Young-A Lee2, Jin-A Jung1
1Department of Pediatrics, College of Medicine Dong-A University, Busan, Korea
2Tom Kid Pediatrics, Ulsan, Korea
극소 저체중출생아에서 강화된 모유와 미숙아 전용분유가 성장 및 임상에 미치는 효과
최희원1, 김묘징1, 이영아2, 정진아1
1동아대학교 의과대학 소아과학교실
2개구쟁이소아과의원
Correspondence: 
Jin-A Jung, Email: jina1477@dau.ac.kr
Abstract
Purpose
: A prospective, controlled trial was conducted to evaluate growth, efficacy, safety and nutritional status for very low birth weight infants fed with human milk fortified with Maeil human milk fortifier (Maeil HMF ; Maeil Dairies Co., Ltd.).
Methods
: We enrolled 45 premature infants with a birth weight <1,500 g and gestational age <33 weeks, who were born at Dong-A University Hospital from October, 2006 through December, 2007. They were divided into 2 groups: infants in one group were fed with human milk fortified with HMF , and the second were fed with preterm formula. Growth, biochemical indices, feeding tolerance, and other adverse events in each group were assessed serially and compared relatively. Follow-up data were also collected after discharge at 1, 3, and 6 months corrected age.
Results
: Characteristics of the 2 groups including average gestational age, birth weight, sex, respiratory distress syndrome, patent ductus arteriosus, and other adverse events (sepsis, retinopathy of prematurity, and intraventricular hemorrhage) showed no significant difference. Average feeding start day (8.00?.27 d vs. 8.86?.37 d) (P=0.99) and the number of days required to reach full feeding after start feeding (41.78?0.47 d vs 36.86?0.63 d) (P=0.55) were not significantly different in the group fed human milk fortified with HMF when compared with the group that was fed preterm formula. The duration of total parenteral nutrition and the incidence of feeding intolerance also showed no differences between the 2 groups. Although infants fed with human milk fortified with HMF showed faster weight gain than those fed with preterm formula at the end stage of the admission period, other growth indices of the two groups showed no significant difference. No significant correlations were found between the 2 groups with regard to weight gain velocity, height gain velocity, head circumference velocity, and post- discharge follow up growth indices.
Conclusion
: Premature infants fed human milk fortified with HMF showed no significant difference compared with those fed preterm formula in growth, biochemical indices, and adverse events. Using human milk fortifier can be an alternative choice for very low birth weight infants, who need high levels nutritional support even after discharge from NICU.
Key Words: Very low birth weight infants, Preterm formula, Breast milk, Human milk fortifier, Human milk fortification


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