Willeitner Andrea, Anderson Michael, Lewis Jami
*Department of Pediatrics, Neonatal-Perinatal Medicine†Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
J Pediatr Gastroenterol Nutr. 2017 Nov;65(5):574-578. doi: 10.1097/MPG.0000000000001638.
The aim of the study was to assess clinical feasibility and tolerance of concentrated preterm formula at 30 kcal/oz (CPF30) to fortify human milk to a caloric density of 24 kcal/oz, compared to conventional powdered human milk fortifier (PHMF).
Very low birth weight neonates were stratified by birth weight and randomized to receive human milk fortification using CPF30 or PHMF. Infants were monitored from first introduction of human milk fortification, until fortified feeds were well tolerated. Primary outcome was weight gain; secondary outcomes included other measures of feeding intolerance (residual gastric aspirates, feeds held, prokinetic therapy), sepsis, and death. The clinical and study personnel were blinded to the intervention.
No significant differences in weight gain or other measures of feeding tolerance were demonstrated between CPF30 and PHMF. Macronutrient intake was similar between both groups. Infants with a birth weight of ≥ 1000 g who received CPF30, experienced fewer days NPO (nil per os; nothing per mouth) and a trend toward lower incidence of NEC, compared with those who received PHMF.. The amount of human milk consumed was significantly lower in the CPF30 group.
Both fortifiers were similarly well tolerated. Fortification of human milk with CPF30 is a safe and feasible alternative to conventional PHMF.
本研究旨在评估热量为30千卡/盎司的浓缩早产配方奶粉（CPF30）将母乳强化至24千卡/盎司热量密度的临床可行性和耐受性，并与传统的粉状母乳强化剂（PHMF）进行比较。
极低出生体重儿按出生体重分层，随机接受使用CPF30或PHMF的母乳强化。从首次引入母乳强化开始监测婴儿，直至强化喂养耐受良好。主要结局是体重增加；次要结局包括其他喂养不耐受指标（胃残余抽吸物、暂停喂养、促动力治疗）、败血症和死亡。临床人员和研究人员对干预措施不知情。
CPF30和PHMF在体重增加或其他喂养耐受性指标上无显著差异。两组的宏量营养素摄入量相似。出生体重≥1000克且接受CPF30的婴儿与接受PHMF的婴儿相比，禁食天数更少，坏死性小肠结肠炎的发病率有降低趋势。CPF30组消耗的母乳量显著更低。
两种强化剂的耐受性相似。用CPF30强化母乳是传统PHMF的一种安全可行的替代方法。
