439 - Human Milk- versus Bovine Milk-Derived Fortifier Use in Very Low Birth Weight Infants: Impact on Growth and Vitamin D Status

Poster Number: 439
Publication Number: 439.334

Emmanuelle Lavassani, Albany Medical College, Albany, NY, United States; Kate A. Tauber, Albany Medical College, Albany, NY, United States; Jennifer Cerone, Albany Medical College, Albany, NY, United States; Jennifer Ludke, Albany Medical College, Albany, NY, United States; Upender Munshi, Albany Medical College, Albany, NY, United States

Background: Bovine milk-derived fortifier (BMDF) has been the standard of care for human milk fortification in premature infants, but the introduction of human milk-derived fortifier (HMDF) provides the opportunity for an exclusive human milk diet, which reduces the risk of adverse outcomes but may not provide enough protein for adequate growth compared to BMDF. There is insufficient data in current literature comparing the effects of BMDF and HMDF on growth and serum 25 hydroxy vitamin D (25OHD) levels in preterm very low birth weight (VLBW) infants.

Objective: Study BMDF versus HMDF on growth and vitamin D levels in premature VLBW infants in the first 2 months of life.

Design/Methods: IRB-approved retrospective chart review of VLBW infants admitted to the Neonatal Intensive Care Unit (NICU) within 24 hours of birth, defined as weight < 1500 g and gestational age ≤ 32 + 6/7 weeks at birth. Only infants receiving exclusively human milk (mother’s milk and/or donor milk) were analyzed after being separated into those fortified with BMDF and those fortified with HMDF. Analysis of growth parameters and vitamin D status was done at 4 and 8 weeks postnatal age.

Results: 517 infants were eligible but only 139 received exclusive human milk from birth to 4 weeks of age and were enrolled. Of the 139 infants, 44 continued to receive exclusively human milk between 4 and 8 weeks of age. Birth demographic characteristics are shown in Table 1. There was no statistically significant difference between BMDF and HMDF groups in growth parameters, including weight, head circumference, or length gain, at 4 and 8 weeks post-birth (Table 2). Serum 25OHD levels in the HMDF group were significantly increased in comparison to the BMDF group, 30.6 ± 9.0 ng/mL vs 28.2 ± 10.9 ng/mL (P=0.02), at 4 weeks post-birth despite receiving less vitamin D supplementation than the BMDF group, 13.7 ± 3.3 μg/day vs 18.3 ± 3.7 μg/day (P=0.0001) (Figure 1). Differences in vitamin D status and supplementation were not significant at 8 weeks of age. NEC rates were low and not statistically different between the groups.Conclusion(s): Growth parameters were similar between the HMDF and BMDF groups suggesting that HMDF provides adequate nutrients for growth. The HMDF group had significantly increased serum vitamin D levels at 4 weeks compared to the BMDF group. A difference was not seen at 8 weeks likely due to low numbers of infants in that cohort. Infants who received HMDF required lower vitamin D supplementation to achieve higher serum levels than infants that received BMDF. Further studies with larger numbers are needed to confirm these results.
Emmanuelle Lavassani CVEmmanuelle Lavassani_CV.pdf
Table 1. Demographics of the HMDF and BMDF groups receiving fortifier at 4-weeks of age.HMDF = human milk-derived fortifier; BMDF = bovine milk-derived fortifier; SD = standard deviation; HC = head circumference.