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Question 1 Is there an increased risk of necrotising enterocolitis in preterm infants whose mothers' expressed breast milk is fortified with multicomponent fortifier?
  1. Iain Martin1,
  2. Lesley Jackson2
  1. 1School of Medicine, University of Glasgow, Glasgow, UK
  2. 2Neonatal Unit, Southern General Hospital, Glasgow, Glasgow, UK
  1. Correspondence to Dr Lesley Jackson, Neonatal Unit, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, UK; Lesley.Jackson{at}ggc.scot.nhs.uk

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Scenario

A premature infant (30 weeks) weighing 1050g was recently admitted to the neonatal intensive care unit after an uncomplicated delivery. You have spoken to the mother regarding the benefits of expressed breast milk (EBM) compared to premature formula milk, including the decreased risk of necrotising enterocolitis (NEC), and this is being administered via a nasogastric tube. At the ward round the consultant suggests the addition of EBM fortifier to ensure the baby has an adequate intake of macronutrients and micronutrients and to maximise extra-uterine growth. You wonder if the addition of a cow's milk-based fortifier to EBM will confer an increased risk of NEC and decide to find out more.

Structured clinical question

In premature infants (<37 weeks) [patient] does supplementation of expressed breast milk with multicomponent fortifier [intervention] increase the risk of necrotising enterocolitis [outcome]?

Search strategy and outcome

MEDLINE (1966–2011) was searched using the search terms: (preterm OR neonate OR infant) AND (human milk OR breast milk OR EBM) AND (fortifier OR fortified OR multicomponent) …

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