Published online by Cambridge University Press: 10 December 2009
Nutrition support of the premature infant must be designed to compensate for metabolic and gastrointestinal immaturity, immunologic compromise, and associated medical conditions. Nutritional needs are determined based on intrauterine rates of growth and nutrient accretion. The beneficial effects of human milk extend to the feeding of premature infants (Chapter 26). Human milk is capable of satisfying most of the needs of premature infants if careful attention is given to nutritional status. Nevertheless, because of their specialized needs the human milk-fed premature infant may require nutrient supplementation, or fortification, to maintain optimal nutritional status while deriving benefits from enhanced host defense, neurologic development, and gastrointestinal function. The nutritional adequacy of human milk for premature infants may be limited for several reasons. The nutrient content of the milk may be inadequate for their needs and the variability in nutrient content results in an unpredictable nutrient intake for an infant who cannot feed ad libitum. Infants often receive restricted milk intakes. Mothers often are unable to supply sufficient milk to meet the needs of the infant throughout the hospitalization. As a consequence, nutrient inadequacy may manifest in the premature infant fed unfortified human milk. This review will focus on the feeding of fortified human milk to the premature infant.
Composition of preterm milk
Milk from mothers who give birth prematurely (preterm milk) generally has greater concentrations of immune proteins, lipid, energy, vitamins, calcium, sodium, and trace elements than in corresponding term milk.