1 - Nutrition Unit, Maternidade Dr. Alfredo da Costa, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 2890-495 Lisbon, Portugal
2 - Research Unit, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 1169-045 Lisbon, Portugal
3 - Neonatal Intensive Care Unit, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 1169-045 Lisbon, Portugal
4 - Centre of Statistics and Its Applications, University of Lisbon, 1749-016 Lisbon, Portugal
5 - Neonatal Intensive Care Unit, Maternidade Dr. Alfredo da Costa, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 2890-495 Lisbon, Portugal
6 - Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal
7 - CINTESIS—Center for Health Technology and Services Research, 4200-450 Porto, Portugal
8 - Nutrition Lab, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 1169-045 Lisbon, Portugal
9 - Medicine of Woman, Childhood and Adolescence Academic Area, NOVA Medical School, Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal
10 - CHRC—Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal
- Nutrients 2023, 15, 1533. https://doi.org/10.3390/nu15061533
The optimal method for human milk (HM) fortification has not yet been determined. This study assessed whether fortification relying on measured HM macronutrient content (Miris AB analyzer, Upsala, Sweden) composition is superior to fortification based on assumed HM macronutrient content, to optimize the nutrition support, growth, and body composition in infants born at <33 weeks’ gestation. In a mixed-cohort study, 57 infants fed fortified HM based on its measured content were compared with 58 infants fed fortified HM based on its assumed content, for a median of 28 and 23 exposure days, respectively. The ESPGHAN 2010 guidelines for preterm enteral nutrition were followed. Growth assessment was based on body weight, length, and head circumference D z-scores, and the respective growth velocities until discharge. Body composition was assessed using air displacement plethysmography. Fortification based on measured HM content provided significantly higher energy, fat, and carbohydrate intakes, although with a lower protein intake in infants weighing _ 1 kg and lower protein-to-energy ratio in infants weighing < 1 kg. Infants fed fortified HM based on its measured content were discharged with significantly better weight gain, length, and head growth. These infants had significantly lower adiposity and greater lean mass near term-equivalent age, despite receiving higher in-hospital energy and fat intakes, with a mean fat intake higher than the maximum recommended and a median protein-to-energy ratio intake (in infants weighing < 1 kg) lower than the minimum recommended.
Palavras Chave: adiposity; body composition; growth velocity; human milk fortification; preterm infants