Considerations in meeting protein needs of the human milk-fed preterm infant

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Preterm infants provided with sufficient nutrition to achieve intrauterine growth rates have the greatest potential for optimal neurodevelopment. Although human milk is the preferred feeding for preterm infants, unfortified human milk provides insufficient nutrition for the very low-birth-weight infant. Even after fortification with human milk fortifier, human milk often fails to meet the high protein needs of the smallest preterm infants, and additional protein supplementation must be provided. Although substantial evidence exists to support quantitative protein goals for human milk-fed preterm infants, the optimal type of protein for use in human milk fortification remains uncertain. This question was addressed through a PubMed literature search of prospective clinical trials conducted since 1990 in preterm or lowbirth- weight infant populations. The following 3 different aspects of protein quality were evaluated: whey-to-casein ratio, hydrolyzed versus intact protein, and bovine milk protein versus human milk protein. Because of a scarcity of current studies conducted with fortified human milk, studies examining protein quality using preterm infant formulas were included to address certain components of the clinical question. Twenty-six studies were included in the review study. No definite advantage was found for any specific whey-to-casein ratio. Protein hydrolyzate products with appropriate formulations can support adequate growth and biochemical indicators of nutrition status and may reduce gastrointestinal transit time, gastroesophageal reflux events, and later incidence of atopic dermatitis in some infants. Plasma amino acid levels similar to those of infants fed exclusive human milk-based diets can be achieved with products composed of a mixture of bovine proteins, peptides, and amino acids formulated to replicate the amino acid composition of human milk. Growth and biochemical indicators of nutrition status are similar for infants fed human milk fortified with human milk protein and bovine milk protein.

Original languageEnglish (US)
Pages (from-to)281-289
Number of pages9
JournalAdvances in Neonatal Care
Volume14
Issue number4
DOIs
StatePublished - Aug 2014

Fingerprint

Human Milk
Premature Infants
Proteins
Milk Proteins
Caseins
Nutritional Status
Amino Acids, Peptides, and Proteins
Growth
Gastrointestinal Transit
Amino Acids
Very Low Birth Weight Infant
Infant Formula
Atopic Dermatitis
Gastroesophageal Reflux
PubMed
Clinical Trials
Diet
Weights and Measures

Keywords

  • Human milk fortifier
  • Neonate
  • Nutrition
  • Preterm infant
  • Protein quality
  • Very lowbirth- weight infants

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Considerations in meeting protein needs of the human milk-fed preterm infant. / Wagner, Julie; Hanson, Corrine K; Anderson Berry, Ann L.

In: Advances in Neonatal Care, Vol. 14, No. 4, 08.2014, p. 281-289.

Research output: Contribution to journalReview article

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