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Early versus Delayed Fortification of Human Milk in Preterm Infants: A Systematic Review.
Neonatology. 2020; 117(1):24-32.N

Abstract

Expressed breast milk (EBM) is commonly supplemented with commercially prepared human milk fortifier to meet the additional nutritional needs of preterm infants. The optimal milk intake at which to introduce fortification is unknown. The objective of this systematic review was to compare the effect of early fortification (EF) versus that of delayed introduction of human milk fortifier (DF) on short-term outcomes including growth, feeding intolerance, length of hospital stay, and maturity at discharge in very-low-birth-weight infants. The search was carried out until March 2019 using 5 electronic databases (PubMed, Ovid Medline, Web of Science, Ovid Embase, and the Cochrane Library). The search was supplemented with a search of the clinical trial registry and reference lists. Eligible studies involved randomized controlled trials that had been designed to compare EF against DF using multi-nutrient fortifier for infants of a birth weight of <1,500 g who were fed exclusively or predominantly EBM. Four authors independently screened the studies for eligibility. A total of 1,972 articles were screened; 2 studies met the inclusion criteria and were included with a total number of participants of 171. The definition of EF and DF was not consistent between the 2 studies. There was no significant impact of EF versus DF on all outcomes. In conclusion, current data are limited and do not provide evidence on the optimal time to start fortification. The definition of EF and DF needs to be agreed upon and further larger randomized controlled trials are required.

Authors+Show Affiliations

School of Medicine, Dentistry and Nursing, Human Nutrition, University of Glasgow, Glasgow, United Kingdom, wesam_y@hotmail.co.uk.Neonatal Unit, Royal Hospital for Children, Glasgow, United Kingdom. NHS Greater Glasgow and Clyde Human Milk Bank, Queen Elizabeth University Hospital, Glasgow, United Kingdom.School of Medicine, Dentistry and Nursing, Human Nutrition, University of Glasgow, Glasgow, United Kingdom.Neonatal Unit, Princess Royal Maternity Hospital, Glasgow, United Kingdom.School of Medicine, Dentistry and Nursing, Human Nutrition, University of Glasgow, Glasgow, United Kingdom.

Pub Type(s)

Research Support, Non-U.S. Gov't
Journal Article

Language

eng

PubMed ID

31326969

Citation

Alyahya, Wesam, et al. "Early Versus Delayed Fortification of Human Milk in Preterm Infants: a Systematic Review." Neonatology, vol. 117, no. 1, 2020, pp. 24-32.
Alyahya W, Simpson J, Garcia AL, et al. Early versus Delayed Fortification of Human Milk in Preterm Infants: A Systematic Review. Neonatology. 2020;117(1):24-32.
Alyahya, W., Simpson, J., Garcia, A. L., Mactier, H., & Edwards, C. A. (2020). Early versus Delayed Fortification of Human Milk in Preterm Infants: A Systematic Review. Neonatology, 117(1), 24-32. https://doi.org/10.1159/000501279
Alyahya W, et al. Early Versus Delayed Fortification of Human Milk in Preterm Infants: a Systematic Review. Neonatology. 2020;117(1):24-32. PubMed PMID: 31326969.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early versus Delayed Fortification of Human Milk in Preterm Infants: A Systematic Review. AU - Alyahya,Wesam, AU - Simpson,Judith, AU - Garcia,Ada L, AU - Mactier,Helen, AU - Edwards,Christine A, Y1 - 2019/07/19/ PY - 2019/02/14/received PY - 2019/06/03/accepted PY - 2019/7/22/pubmed PY - 2019/7/22/medline PY - 2019/7/22/entrez KW - Expressed breast milk KW - Human milk KW - Human milk fortifier KW - Premature infant KW - Preterm infant feeding SP - 24 EP - 32 JF - Neonatology JO - Neonatology VL - 117 IS - 1 N2 - Expressed breast milk (EBM) is commonly supplemented with commercially prepared human milk fortifier to meet the additional nutritional needs of preterm infants. The optimal milk intake at which to introduce fortification is unknown. The objective of this systematic review was to compare the effect of early fortification (EF) versus that of delayed introduction of human milk fortifier (DF) on short-term outcomes including growth, feeding intolerance, length of hospital stay, and maturity at discharge in very-low-birth-weight infants. The search was carried out until March 2019 using 5 electronic databases (PubMed, Ovid Medline, Web of Science, Ovid Embase, and the Cochrane Library). The search was supplemented with a search of the clinical trial registry and reference lists. Eligible studies involved randomized controlled trials that had been designed to compare EF against DF using multi-nutrient fortifier for infants of a birth weight of <1,500 g who were fed exclusively or predominantly EBM. Four authors independently screened the studies for eligibility. A total of 1,972 articles were screened; 2 studies met the inclusion criteria and were included with a total number of participants of 171. The definition of EF and DF was not consistent between the 2 studies. There was no significant impact of EF versus DF on all outcomes. In conclusion, current data are limited and do not provide evidence on the optimal time to start fortification. The definition of EF and DF needs to be agreed upon and further larger randomized controlled trials are required. SN - 1661-7819 UR - https://www.unboundmedicine.com/medline/citation/31326969/Early_versus_Delayed_Fortification_of_Human_Milk_in_Preterm_Infants:_A_Systematic_Review L2 - https://www.karger.com?DOI=10.1159/000501279 DB - PRIME DP - Unbound Medicine ER -
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