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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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