Multicomponent fortification of human breast milk for preterm infants following hospital discharge

Background: Preterm infants are usually growth restricted at hospital discharge. Feeding preterm infants after hospital discharge with nutrient-fortified breast milk (rather than unfortified breast milk) may facilitate more rapid catch-up growth and improve neurodevelopmental outcomes. Objectives: To determine the effect of feeding with multicomponent fortified human breast milk versus unfortified breast milk on growth and development on preterm or low birth weight infants following hospital discharge. Search strategy: The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2007), MEDLINE (1966 - May 2007), EMBASE (1980 - May 2007), CINAHL (1982 - May 2007), conference proceedings, and previous reviews. Selection criteria: Randomised or quasi-randomised controlled trials that compared feeding preterm infants following hospital discharge with multicomponent fortified breast milk compared with unfortified human breast milk. Data collection and analysis: The standard methods of the Cochrane Neonatal Review Group were used, with separate evaluation of trial quality and data extraction by two review authors. Main results: No eligible trials were identified. Authors' conclusions: There are no data from randomised controlled trials to determine whether feeding preterm infants following hospital discharge with multicomponent-fortified breast milk compared with unfortified breast milk affects growth and development. Given the potential for nutrient fortification to affect growth and development, this intervention may merit further assessment. Since fortifying breast milk for infants fed directly from the breast is logistically difficult (and has the potential to interfere with breast-feeding), it would be important to determine if mothers would support a trial of this intervention. It may be that a trial should first focus on infants who are not able to consume ad libitum quantities of breast milk directly from the breast, who have poor growth or nutritional status, or who have ongoing additional metabolic requirements.