Target fortification

Target fortification is used to tailor human milk for the individual preterm infant’s nutritional needs by analysing the milk prior to fortification. By knowing the macronutrient composition of human milk it becomes easy to identify if fortification is needed.

Miris helps you measure the macronutrient composition of human milk enabling individual nutrition for preterm infants.

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The Dilemma

During the last trimester, the fetus has a growth rate that is three times greater than that of a term baby. The dilemma is that preterm babies are born with high energy requirements and low reserves of macronutrients. Furthermore, individual metabolic status, organ maturity and health can vary greatly. Because of this, one feeding regimen cannot be applied to all.

Large variation in human milk

There are large variations in the macronutrient content of human milk used in neonatal care. Mother to mother variation, stage of lactation, and methods of storage and treatment can all affect composition.

The only way to be certain of the macronutrient composition is to analyse. Miris Human Milk Analyzer provides the information that clinicians need to decide optimal macronutrient composition to be given to each individual preterm infant.

The macronutrient content of human milk used in neonatal care can vary greatly.1

The need to optimise nutrition

Although human milk boosts immunity it may not always meet the nutritional requirements of each individual. Miris Human Milk Analyzer helps develop individualised nutritional programmes that mimic intrauterine growth according to specific nutritional requirements of the three birth weight classes:  

  • Extreme low birth weight infants                        < 1000 g
  • Very low birth weight infants                              < 1500 g
  • Low birth weight infants                                     < 2500 g

The concentration of protein in human milk declines significantly after birth. The ESPGHAN 2010 guidelines2 indicate that most preterm babies have a protein deficit that is linked to their weight and composition of their feed. Extreme and very low birth weight babies often need additional energy and protein to enable growth similar to intrauterine growth.

Left: Protein content of human milk declines after birth. 
Right: The specific protein requirements of preterm babies.4

References

1) Wojcik KY, Rechtman DJ, Lee ML. Macronutrient Analysis of a Nationwide Sample of Donar Breast Milk J Am Diet Assoc 2009;109:137- 140.

2) Agostoni et al. Enteral nutrient supply for Preterm Infants: Commentary from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. JPGN 2010; 50: 85-91.

3) Selander B, Polberger S. Improved Individualized Nutritional Management of Preterm Infants Using a Bedside, Low-Volume Human Milk Analyzer (poster). Pediatric Academic Societies’ Annual Meeting, Toronto, May 2007.

4) Ziegler EE, Carlson SJ. Early nutrition of very low birth weight infants. J Maternal Fetal Neonatal Med 2009; 22:191-197.

Target fortification. An interventional study.

Is targeted fortification of human breast milk an optimal nutrition strategy for preterm infants? An interventional study by L Morlacchi, D Mallardi, M L Giannì, P Roggero, O Amato, P Piemontese, D Consonni, and F Mosca, J Transl Med. 2016; 14:195.

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