Investigation of the effect of early and late breast milk enrichment on growth parameters in preterm infants: A randomized clinical trial

Background and aims: This study aimed to investigate and compare the effect of early and late breast milk fortification on growth parameters in preterm infants. Methods: In this clinical trial, ۹۰ preterm infants (۲۸-۳۲ weeks) admitted to the neonatal intensive care unit (NICU) of Hajar Hospital in Shahrekord, Iran were randomly divided into three groups. The fortification was performed when the milk intake reached ۳۰ (group A), ۷۰ (group B), and ۱۰۰ cc/kg (group C). The height, weight, and head circumference of newborns were measured at the beginning of birth and ۴ weeks after the birth. The incidence of sepsis and necrotizing enterocolitis, and milk tolerance were investigated as well. All analyses were conducted with Stata software, and P values < ۰.۰۵ were considered statistically significant. Results: The value changes in the height, weight, and head circumference in all three groups at ۴ weeks were significant (P < ۰.۰۰۱). The mean weight changes in the A, B, and C groups were ۷۲۷.۳۳ ± ۱۶۳.۸۵, ۹۴۷.۳۳ ± ۱۵۵.۳۸, and ۸۰۸.۶۶ ± ۱۶۸.۸۲, indicating a statistically significant difference (P < ۰.۰۰۱). Further, the mean change of weight after ۴ weeks showed statistically significant differences (P < ۰.۰۰۱) among the A, B, and C groups. The weight gain in the B group was significantly higher than that of the A and C groups (P < ۰.۰۵); however, no significant difference was observed in the mean weight gain between the A and C groups (P = ۰.۲۶۴). Conclusion: The breast milk fortification when the milk intake reached ۷۰ cc/kg had better efficiency on neonatal weight gain compared with the early and delayed fortification.

Keywords:

Preterm infant , Colostrum , Milk fortifier