Human Milk Fortifiers:  Nourishing My Preemie

Human Milk Fortifiers:  Nourishing My Preemie


Breast Milk

It is the best source of nutrition for a baby. It provides the baby with exactly the right amount of nutrients, minerals, and vitamins. Not only does it give the baby supplements for growth, but it also guards the baby against life-threatening diseases.

Breast milk provides protection from diseases such as Necrotizing Enterocolitis (NEC). It is a life-threatening condition common in premature babies. Breast milk also contains antibodies that boost the immunity of the baby and protects it against infections and allergies.

According to a study, feeding breast milk to the baby has also been linked to higher intelligence levels in children. It helps the mother and baby bond well and protects the baby from diseases like diabetes, later in life.

Not only does breast milk protect, but it also nourishes the baby and helps the mother. While breastfeeding, a mother can quickly lose weight since it uses up a lot of her energy. It returns the uterus to its previous size. It also lowers the risk of breast cancer and osteoporosis in feeding mothers.

If for some reason, mother’s milk is not available to the baby, then donor breast milk from milk banks can be used to nourish the baby.

Additional Nutritional Needs Of Preterm Babies

Sometimes, in case of preterm, low weight or unhealthy babies, breast milk simply might not be sufficient for the needs of the baby. According to some studies, premature babies need more nutrients than what breast milk can provide.

Sometimes additional supplements in the form of calcium and Vitamin D are needed to strengthen the bones of the baby. In some cases, the mother herself might have specific vitamin deficiencies and therefore cannot provide them to the baby adequately.

This does not mean that all premature or preterm babies need additional supplements. Only a minimal number of premature babies have needs that cannot be met by breast milk. This can only be assessed by doctors in charge of the premature newborn unit or another specialist from a related field.

What Is A Human Milk Fortifier?

Human Milk Fortifiers (HMF) is commercially produced supplements, made mostly from cow milk to be added to the human milk, for the baby. Fortifiers of different varieties and components are available in the market. The main ingredients present in all fortifiers are proteins and minerals.

Fortification of human milk is important, because the demand for proteins and minerals required by preterm babies in critical care units may be more than what breast milk can provide. They also contain varying amounts of vitamins, electrolytes, and extra calories.

Studies have shown short-term improvement in the weight and the growth of the baby with the use of fortifiers. Another research has shown an increase in the strengthening and lengthening of bones due to human milk fortification. This increase will eventually lead to faster growth regarding height, weight and head size.

Guidelines To Use Fortified Milk

Use of fortified milk is indicated in babies with a weight of less than 2000g or 2kg. Infants weighing between 2 and 2.5 kg can also benefit by drinking fortified milk, especially if they have shown a decrease in feeding or growth rate.

Starting fortified milk should be delayed till a baby is feeding more than 25 ml of milk a day. Even if the baby is drinking more than 25ml milk immediately after birth, fortified milk should not be started until it is four days old.

Babies, who were being given breast milk with milk fortifiers before mouth feedings were stopped, should be started on the same feed. Usually, babies should be given fortified milk with a concentration of 24 kcal/oz.

To feed the baby, wash hands and the milk bottle. Warm the breast milk to room temperature or keep it slightly warmer. Add a tablespoon of the formula to the cup of milk. Thoroughly mix it so that it doesn’t become lumpy. Gently shake the bottle and warm it in water. Do not use a microwave to heat it. Test the temperature of the milk. If there is any milk left in the bottle, throw it away.

The baby can only be given concentrated formulas if the amount of fluid is being limited in the baby. It is also indicated if the baby is born with a metabolic disease of the bones, as it will require extra calcium and phosphate for good bone health. Higher protein supplements can also be given if the baby is not gaining weight appropriately.

Risks Of Milk Fortification

Human milk fortifiers are made of cow milk that may increase the risk of developing life-threatening respiratory, ear and abdominal infections like Necrotizing Enterocolitis.

Some studies have shown that the use of fortifiers increases the chances of re-hospitalizations later. They also associate the use of milk fortifiers with a decrease in survival. According to these studies, even though weight gain might be slower with the use of breast milk, intellectual development is much more as compared to the use of milk fortifiers.

With the addition of the milk fortifiers to the baby’s diet, there are chances of excess accumulation of minerals. If there is a huge lack of vitamins, then an excess of these fortifiers is equally worse, as they might even damage the organs of the baby.

Researchers have linked the slow growth of a premature baby, by only feeding breast milk, with a reduction in the risks of developing diseases such as obesity, diabetes mellitus, heart problems, and even cancer.

As for the benefits of a fortifier for bones, these were found to be short-term. For a long-term solution for bone health and development, unfortified breast milk is the better choice.


There seem to be some benefits of using a milk fortifier, but these benefits are outweighed by the increased amount of risks associated with its usage. Therefore, even though the growth rate of the premature baby will be much slower using unfortified milk, it is still the only source of the nutrition with short and long-term benefits and no side effects.