Haemoglobin concentration depends on protein intake in small preterm infants fed human milk.

Studies have shown that early anaemia of prematurity cannot be prevented by iron or vitamin supplementation. We studied 35 infants of birthweight less than 1520 g and mean gestational age 30.4 weeks who were fed either human milk alone or human milk supplemented with human milk protein. The vitamin and iron status were the same in both groups but the concentration of haemoglobin was significantly higher at the ages 4 to 10 weeks in the protein supplemented infants. Reticulocytosis occurred earlier in the protein supplemented infants. The findings on haemoglobin and reticulocytes were similar in 18 infants who received no blood transfusions. We conclude that human milk protein supplementation can increase the haemoglobin concentration of very low birthweight infants in the early weeks of life and that the protein content in human milk may be insufficient to satisfy their needs.