Comparison of feed fortifying regimes for weight gain in preterm babies—A randomized control trial

Abstract

Background: The fortification of human milk has been recommended for all babies <2 kg as the standard of care for rapid weight gain. The search for an ideal fortifying agent still continues. Objectives: The primary objective was to study the preterm weight gain with three different types of fortifiers (carbohydrate-rich, protein-rich, and fat-rich) with a randomized control trial. Materials and Methods: A randomized control trial in a level III Neonatal Intensive Care Unit (NICU). Preterms with < 34 weeks gestation and birth weight <2kg who were exclusively breast fed were included in the study and grouped into three groups. Feeds were fortified and the weight gain per day measured. The outcome was measured as the median weight gain in each group. Results: The median weight gain with carbohydrate-, protein-, and fat-rich fortifier was 11.8, 14.75, and 9.7 g/kg/day, respectively. It is evident that fat-rich group took more days to get discharged. No one developed feed intolerance or necrotizing enterocolitis. Conclusion: Protein-rich human milk fortifier gives higher median weight gain followed by carbohydrate-rich and fat-rich.