Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
J Pediatr Gastroenterol Nutr. 2024 Jun;78(6):1389-1397. doi: 10.1002/jpn3.12190. Epub 2024 Apr 8.
The safety and feasibility of human milk fortification with bovine colostrum (BC) were investigated in very preterm infants (FortiColos trial, NCT03537365). The BC product contained lower calcium, phosphate, and iron levels compared to the conventional fortifier (CF). We tested whether fortification with BC plus extra phosphate was sufficient to support the infants' mineral status assessed by blood biochemistry.
In a randomised controlled trial (FortiColos, NCT03537365), mineral status was compared after fortification with BC versus CF. Blood calcium, phosphate, and haemoglobin were determined before and up to 3 weeks after the start of fortification (at the mean age of 8-9 days). The maximum supplemental doses of calcium, phosphate, and iron given were retrieved from patient medical records. Results were adjusted for gestational age, birth weight, and enteral nutrition with the mother's own milk and/or donor human milk.
Blood values of calcium, phosphate, and haemoglobin were similar between groups. Infants in both groups required supplementation with calcium and phosphate, but infants fed BC required higher maximum doses of phosphate and calcium (p < 0.05) to maintain acceptable blood values. Regardless of fortification groups, the most immature (<29 weeks of gestation) and small for gestational age infants showed a higher risk for requiring additional phosphate (odds ratio [OR]: 3.9, p < 0.001; OR: 2.14, p = 0.07, respectively).
The use of BC as a fortifier for human milk requires additional phosphate and calcium relative to a CF. Regardless of the fortification product, the most immature and small infants require additional mineral supplementation.
研究用人牛初乳强化人乳对极早产儿（FortiColos 试验，NCT03537365）的安全性和可行性。与常规强化剂（CF）相比，牛初乳（BC）产品的钙、磷和铁含量较低。我们测试了用 BC 加额外的磷强化是否足以支持通过血液生化评估婴儿的矿物质状况。
在一项随机对照试验（FortiColos，NCT03537365）中，比较了用 BC 强化与 CF 强化后的矿物质状况。在强化开始前（平均年龄为 8-9 天）和开始后 3 周内测定血钙、血磷和血红蛋白。从患者病历中检索出给予的钙、磷和铁的最大补充剂量。结果根据胎龄、出生体重以及母亲自己的奶和/或捐献人奶进行肠内营养进行了调整。
两组间血钙、血磷和血红蛋白值相似。两组婴儿均需补充钙和磷，但用 BC 喂养的婴儿需要更高剂量的磷和钙（p<0.05）来维持可接受的血液值。无论强化组如何，最不成熟（<29 周胎龄）和小于胎龄的婴儿需要额外的磷（优势比[OR]：3.9，p<0.001；OR：2.14，p=0.07）的风险更高。
与 CF 相比，用人牛初乳作为人乳强化剂需要额外的磷和钙。无论使用哪种强化剂，最不成熟和最小的婴儿都需要额外的矿物质补充。
