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Multinutrient fortification of human breast milk for preterm infants following hospital discharge

  1. Lauren Young1,
  2. Nicholas D Embleton2,
  3. Felicia M McCormick3,
  4. William McGuire1,*

Editorial Group: Cochrane Neonatal Group

Published Online: 28 FEB 2013

Assessed as up-to-date: 10 SEP 2012

DOI: 10.1002/14651858.CD004866.pub4

How to Cite

Young L, Embleton ND, McCormick FM, McGuire W. Multinutrient fortification of human breast milk for preterm infants following hospital discharge. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD004866. DOI: 10.1002/14651858.CD004866.pub4.

Author Information

  1. 1

    Hull York Medical School & Centre for Reviews and Dissemination, University of York, York, UK

  2. 2

    Royal Victoria Infirmary, Newcastle Neonatal Service, Newcastle upon Tyne, UK

  3. 3

    University of York, Mother and Infant Research Unit, Department of Health Sciences, York, UK

*William McGuire, Hull York Medical School & Centre for Reviews and Dissemination, University of York, York, Y010 5DD, UK. William.McGuire@hyms.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 28 FEB 2013

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

Background

Preterm infants are usually growth restricted at hospital discharge. Feeding preterm infants after hospital discharge with multinutrient fortified breast milk rather than unfortified breast milk may facilitate more rapid catch-up growth and improve neurodevelopmental outcomes.

Objectives

To determine the effect of feeding preterm infants following hospital discharge with multinutrient fortified human breast milk versus unfortified breast milk on growth and development.

Search methods

We used the standard search strategy of the Cochrane Neonatal Review Group. This included electronic searches of the Cochrane Central Register of Controlled Trials Register (CENTRAL, The Cochrane Library, 2012, Issue 3), MEDLINE, EMBASE and CINAHL (until August 2012), conference proceedings, and previous reviews.

Selection criteria

Randomised or quasi-randomised controlled trials that compared feeding preterm infants following hospital discharge with multinutrient fortified breast milk compared with unfortified human breast milk.

Data collection and analysis

We extracted data using the standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors and synthesis of data using risk ratio, risk difference and mean difference.

Main results

We identified two small trials involving a total of 246 infants. These did not provide evidence that multinutrient fortification of breast milk for three to four months after hospital discharge affected rates of growth during infancy. One trial assessed infants at 18 months corrected age and did not find any statistically significant effects on neurodevelopmental outcomes.

Authors' conclusions

The limited available data do not provide convincing evidence that feeding preterm infants with multinutrient fortified breast milk compared with unfortified breast milk following hospital discharge affects important outcomes including growth rates during infancy. There are no data on long-term growth. Since fortifying breast milk for infants fed directly from the breast is logistically difficult and has the potential to interfere with breast feeding, it is important to determine if mothers would support further trials of this intervention.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Multicomponent fortification of human breast milk for preterm infants following hospital discharge

Preterm infants are often much smaller than term infants by the time that they are discharged home from hospital. This review appraised trials that evaluated whether feeding these infants with breast milk fortified with added nutrients rather than unfortified breast milk would increase growth rates and benefit development. We found only two small trials (involving 246 infants) of this intervention. These trials did not provide consistent evidence that multinutrient fortification affects growth rates during infancy. Further trials are needed to resolve this question and to assess long-term effects on growth and development.