Department of Pediatrics - Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands.
Newcastle Neonatal Service, Newcastle Hospitals NHS Trust, Newcastle upon Tyne, United Kingdom.
Nestle Nutr Inst Workshop Ser. 2021;96:72-85. doi: 10.1159/000519397. Epub 2022 May 10.
Mother's own milk is universally recognized as the optimal source of nutrition for preterm infants, although most authorities agree a multi-nutrient fortifier must be added in order to support nutrient accretion at a rate comparable to in utero. Nevertheless, many preterm infants face a gap between achieved growth and what could have been achieved in utero. In this narrative review, we provide an overview on the macronutrient content in mother's own milk and donor milk and how this can be enhanced by the various available multi-nutrient fortifiers. We describe their general compositions and formulation, as well as several of their theoretical and practical advantages and drawbacks. In addition, differences between standardized fortification, or a more individualized approach like adjusted and targeted fortification are discussed. The optimal strategy however remains to be elucidated, and more experimental well-powered studies are therefore urgently needed. Until then, financial considerations and practical capabilities are likely to be the main drivers of local fortification strategies.
虽然大多数权威机构都认为，为了支持早产儿以与宫内生长速度相当的速度积累营养，必须添加多种营养素强化剂，但母乳仍然被普遍认为是早产儿最佳的营养来源。然而，许多早产儿的生长情况与宫内生长情况之间存在差距。在这篇叙述性综述中，我们概述了母乳和捐赠奶中的宏量营养素含量，以及各种可用的多种营养素强化剂如何增强其含量。我们描述了它们的一般组成和配方，以及它们在理论和实践上的一些优缺点。此外，还讨论了标准化强化与更个体化的强化方法（如调整和靶向强化）之间的差异。然而，最佳策略仍有待阐明，因此迫切需要进行更多有说服力的实验性研究。在此之前，经济考虑因素和实际能力可能是当地强化策略的主要驱动因素。
