Comparison of Outcomes of Preterm Infants Who Received Human Milk-Based vs. Bovine-Milk Based Human Milk Fortifier



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Background: Bovine (BOV) or human milk-based fortifier (HUM) is used to add necessary macronutrients to mother's own breastmilk. HUM has been shown to improve growth outcomes and decrease morbidities in infants<1250 grams (g) birth weight (BW). Data is scant about outcomes for neonates 1250-1500g BW. Aim: Compare neonatal outcomes of infants 1250-1500g BW fed HUM vs BOV. Methods: This retrospective cohort study examined data from 150 babies 1250-1500g BW born Jan. 2016-Dec. 2018. Nutrition outcomes included days to full feeds (130 mL/kg/day), parenteral nutrition days, weight, length, and head circumference data. Nutritional z-scores were calculated using Fenton 2013 curves. Clinical outcomes included common neonatal morbidities. Outcomes were analyzed through statistical testing. Comparisons were adjusted for BW. Results: HUM-fed infants were born earlier, had a lower BW, and lower % of small for gestational age (SGA) infants at birth. The postmenstrual age (PMA) at discharge was not significantly different. HUM-fed infants had higher discharge weight z-score and growth velocity. Conclusions: Despite being more premature and smaller at birth, HUM-fed infants went home at a similar PMA and had less postnatal growth failure. This study demonstrates a HUM diet is associated with improved growth outcomes for infants 1250-1500 g BW. This project was completed with contributions from Jana Unger, Joseph Hagan, Muralidhar Premkumar, and Amy B. Hair from the Texas Children's Hospital.