Milk

Human
Milk

Indications

Nutrients are readily absorbed

Anti-infective factors are present
Decreased incidence of NEC and

sepsis
Nutrient composition is unique
Maternal-infant attachment

enhanced
Maternal emotional support by
family & healthcare team is

indicated to facilitate lactation

Quicker achievement of full enteral

feeding vs premature infant formula

Slower weight gain, but earlier

Concerns
Milk from mothers who deliver
prematurely will often contain a
higher protein concentration than that
found from the mother who deliver at
term.
This elevated protein concentration
decreased by 28 days of lactation and
may not meet the protein needs of the
rapidly growing premature infant
The concentration of protein, calcium,
phosphorus and sodium is too low to

discharge has been demonstrated on

meet the needs of many premature

fortified human milk feedings vs

infants. To increase nutrient density,

premature infant formula

human milk fortifiers should be added

to the milk
Iron supplementation at 2-4 mg/kg is
needed for those infants receiving the
low iron containing fortifiers. For
those who are provided with the
fortifier with iron, no iron
supplementation is needed.
Milk production may be inadequate to
nourish the infant.

Milk

Indications

Concerns

Glucose polymers comprises 50 -60 % of

Feeding should be advanced

for

carbohydrate calories, which decrease the

slowly with the very low

premature

lactose load presented to the osmolality of the

infants

formula
Lactose comprises 40- 50 % of the carbohydrate

calories.
MCTs are 40-50 % of the fat calories. MCTs do

Formula

not require pancreatic lipase or bile salt for

digestion.
Protein is at a higher concentration than that
incorporated into standard infant formula to
meet the increased protein needs of the pre term

infant.
The protein is at 60/40 or 100/0 whey/casein
ratio as compared with 18/82 ratio found in
bovine milk. This whey predominance prevents
the elevation of plasma phenylalanine and

tyrosine levels.
Calcium and phosphorus are two to three times
the concentration found in standard infant
formulas. These levels will maintain normal
serum calcium & phosphorus levels to prevent
osteopenia, and promote calcium and
phosphorus accretion at fetal rate
Sodium, potassium & chloride concentration is
greater than standard infant formula to meet
increased electrolyte needs of premature infants.
Vitamin, trace minerals, and additional minerals
are incorporated into these formulas at high
concentration to meet the infants increased
nutrient need while facilitating a limited volume
intake
Iron fortified formula are available, which
eliminates the need for iron supplementation.

birth weight infant

Vitamin
and
supplementations
indicated
receiving

for
iron

iron
are

the

not
infant

fortified

premature infant formula.