TITLE: FORTIFICATION OF MATERNAL MILK FOR VERY LOW BIRTH WEIGHT (VLBW) PRE-TERM

NEONATES
AUTHOR: A Raeli, S Fanaro, A Atzei, M Puddu, M Moi, V Fanos
Published: 2011 midirs

SUMMARY:
Nutrition of very low birth weight preterm newborn is a challenge for the multi-professional team due to
special conditions such as accelerated metabolism, decrease in body reserves, and higher risk of
complications associated with digestive system immaturity and reduced adaptation capacity when there is
water-electrolyte imbalance.
The concern with providing nutrients to preterm infants can be explained by the need to promote rate of
physical growth and development similar to those of intrauterine life at the same gestational age. Due to a
higher concentration of proteins, fat, calories, electrolytes and minerals, in addition to the maintenance of
specific bioactive function, protection against infections, cognitive and gastrointestinal function and
development of mother-infant bond, maternal milk is considered the best option to feed very low birth
weight preterm infants.
IMPLICATIONS TO:
Nursing profession/practice:
This article is vital to the practice of professional nursing. This article disseminates vital information that
will enhance our skills and practice as a nurse and as a future nurses in dealing with preterm babies with
low birth weight.
Nursing education:
It has been part of our life as a nurse and it our responsibility to disseminate information to our patients
and colleague about the new protocols or updates. This article is essential for us as a student, whereas it
enhances our intellectual capabilities with regards to preterm infants in as to how to manage them.
Nursing research:
Nursing research has a tremendous influence on current and future professional nursing practice, thus
rendering it an essential component of the educational process and research have been a big help when
it comes to nursing world and medical field. It has been an important tool for the continual development of
a relevant body of knowledge in nursing. This article is vital for us as a student nurses but on my
perspective theres an insufficiency with regards to as to what milk has been used in the conducted study
and what the duration of the study is.
REACTION:
Should human milk be fortified for a premature baby? Attempts to fortify human milk for preemies are
very commonIt all sounds great, but there are many problems associated with fortification.
Calcium and phosphorous are often added in attempt to improve early bone mineralization. Protein is
added in an attempt to increase growth rate. Other vitamins and minerals are often added as well. It all
sounds great, but there are many problems associated with fortification: Various studies have found out
that 1. 3 times the protein of human milk, comparing this feed to mothers milk in low-weight babies. The
growth rates were similar, but the high-protein infants had high levels of toxins from protein breakdown
in their blood 2. Non human protein enrichment of mothers milk found more severe illnesses 3. A higher
rate of infection is seen in infants fed fortified breast milk versus those fed only human milk 4. breastfed
preemies eventually show very good bone mineralization with no supplementation. Eventually, much
more research is needed in this area. Vitamin fortifications appear to have little downside, as opposed
to minerals, proteins, or other components.