Background The use of an exclusively human milk (HM)-based diet lowers the incidence of NEC, however concerns exist regarding adequate growth. Frequently, donor and maternal HM have a low caloric content. A HM cream -derived supplement can increase the caloric density of an exclusive HM-based diet.
Objective Determine if premature infants fed an exclusive HM-based diet and a HM cream-derived supplement (Cream) would have equal growth compared to infants fed a standard feeding regimen (Control).
Methods In a prospective randomised study, infants with BW 750–1250 grams (g) were assigned to a dietary group. All infants received mother’s own milk or donor HM, with donor HM-derived fortifier. Cream group also received a HM-derived cream supplement if the HM tested < 20 kcal/oz (infrared HM analyzer). F/U continued until 36 weeks PMA. Primary outcomes included growth velocities and incidences of NEC and sepsis. Non-inferiority was established if the lower bound of weight velocity exceeded -3 g/kg/day.
Results There were no differences in demographics exceptrace (p = 0.02). Theone-sided 95% lower bound of the confidence interval for the difference in meanvelocity (cream-control) was 0.38 g/kg/day.
Conclusions Cream group infants had better weight and length velocity. HM cream-derived supplement should be considered as a supplement to an exclusive HM-based diet.