Target fortification is used to tailor breast milk for the individual preterm infant’s nutritional needs by analysing the milk prior to fortification.Read more
New-borns and their mothers are not prepared for a premature arrival into the world. A preterm baby is born before 37 weeks gestational age and have challenges to face. Thanks to modern neonatal care, more and more preterm babies are saved. The outlook of this important field is developing, as it is a part of the United Nations Sustainable Development Goals:
Good Health & Well-being (target 2), aims to reduce neonatal mortality to at least as low as 12 per 1,000 live births by 2030.
A key contributor to delivering on this mission is the availability and quality of nutrition, as the baby’s growth and health is depending on it.
Preterm babies with their small digestive systems are incredibly fragile and can only take in small feeds. It is therefore of great importance that the human milk given to preterm babies has the right nutritional properties. As the the variability in contents of fat, protein, and energy in breast milk is high, analyzing the macronutrient composition of human milk makes it easy to identify the need for individualized nutrition for each baby to enable better growth, thus contributing to a better outcome for the baby, the family and the hospital.
Most doctors agree that human milk is the best nutrition for premature babies. Research indicate that malnutrition leads to a higher prevalence of heart disease in adulthood and has a negative effect om cognitive development (Arbitol et al 2013/Stephens et al 2009). As there are large variations in macronutrients content of human milk, extreme and very low birth weight babies often need additional energy and protein to enable growth similar to intrauterine growth. Apart from its nutritional properties, human milk kick-starts the immune system and provides hormones and enzymes that promote maturation and digestion.
The need of nutrition varies and depends on the gestational age at which the child was born, postnatal age, state of health, weight, growth pattern, nutritional status and proportion enteral (via gastrointestinal tract) and parenteral (intravenous) nutrition. Nutrition intake should thus be calculated individually at frequent intervals. Swedish guidelines for macronutrient intake for ELGA infants are protein intake of 4-4.5 g/kg/day in full enteral nutrition, carbohydrates intake of 9-15 g/kg/day in full enteral nutrition, and lipids intake of 5-8 g/kg/day in full enteral nutrition.
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