Tiniest premature babies fare worse with cow milk fortifiers

Human-based milk fortifiers offer better health outcomes for severely underweight, premature babies when compared to traditional, cow-based milk fortifiers, a new study suggests.

More than 380,000 babies are born prematurely in the United States each year, according to the March of Dimes. These babies are often severely underweight babies and struggle to get the nutrients they need from breast milk alone, so neonatal intensive care units provide an additional milk fortifier, either in the form of cow’s milk or manufactured from donor breast milk, to keep them healthy.

For a new study in the journal Neonatology Today, researchers conducted a meta-analysis of various studies involving more than 450 severely underweight, premature babies in the United States, Canada, and Austria who received either traditional cow-based milk fortifiers or human-based milk fortifiers.

By comparing the babies’ health outcomes, the researchers found that babies fed cow milk fortifiers were more than three times as likely to develop necrotizing enterocolitis, a life-threatening intestine disease, and more than twice as likely to develop retinopathy of prematurity, an eye disorder that can lead to blindness.

“Everyone wants what’s best for these underweight, premature babies, and choosing the best type of milk fortifiers for feeding can help lead to improved health outcomes,” says Jan Sherman, a professor in the Sinclair School of Nursing at the University of Missouri.

“Nearly half of neonatal intensive care units in the United States, including the one at MU Children’s Hospital, are already using human-based milk fortifiers. If we can reduce these cases of necrotizing enterocolitis, if we can preserve their eye sight and reduce the risk of infection, that will benefit the babies’ health in the long term.”

Neonatal intensive care units can use this research in evaluating the nutritional supplements they give to severely underweight, premature babies, who have a higher risk of death or disease than babies born after a full nine-month pregnancy.

“Our research is geared toward better understanding if we can avoid cow’s milk fortifiers while still feeding premature infants well,” says coauthor Alan Lucas, a professor at University College in London.

“The most current evidence suggests that a diet with entirely human milk and enriched feeds manufactured from donated human milk will meet the nutritional needs of the baby without the potential negative health effects that can come with a cow milk fortifier.”

Additional coauthors are from Beth Israel Deaconess Medical Center; the University of California, San Francisco; and the University of Texas at Austin.

Source: University of Missouri

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