Background Fortification of human milk (HM) is a common clinical practice to adapt human milk to the nutritional needs of very low birth weight infants. The optimal method for HM fortification still remains to be determined and a great variety of protocols are currently used in the neonatal intensive care units.
Objective Since it is believed that the standard fortification is insufficient to meet the needs of VLBW, we designed a randomized prospective study in which blind fortification was administered in three different amounts of fortifier and aimed to assess short term growth and metabolic responses of preterm infants.
Methods Eligible infants were randomized into three groups; standard fortification (SF), moderate fortification (MF) and aggressive fortification (AF) groups. Short term growth, feeding intolerance and urea, calcium, phosphorus, alkaline phosphatase levels were assessed.
Results Twenty six, 29 and 29 infants were eligible in SF, MF and AF group, respectively. The baseline characteristics of the groups were similar. Daily weight gain, length at discharge did not differ between groups however head circumference was significantly higher in MF and AF group when compared with SF group. Urea, calcium, phosphorus, alkaline phosphatase levels were similar between groups.
Conclusion We demonstrated that blind fortification of HM even with higher amounts than recommended by commercials was safe and did cause a marked effect on weekly increase in head circumference but not on the other anthropometric measurements and metabolic responses of preterm infants.