1. Introduction
milk, weight gain
PRETERM BIRTH, VERY LOW BIRTH WEIGHT INFANT
Human milk is recommended for very low birth weight infants. Their nutritional needs are high, and the fortification of human milk is a standard procedure to optimize growth. Targeted fortification accounts for the variability in human milk composition. It has been a promising alternative to standard fixed-dose fortification, potentially improving short-term growth. In this trial, preterm infants (≤32 weeks of gestation) were randomized to receive human milk after standard fortification (HMF, Nutricia) or tailored fortification with modular components of proteins (Bebilon Bialko, Nutricia), carbohydrates (Polycal, Nutricia), and lipids (Calogen, Nutricia). The intervention started when preterms reached 80 mL/kg/day enteral feeds. Of the target number of 220 newborns, 39 were randomized. The trial was interrupted due to serious intolerance in five cases. There was no significant difference in velocity of weight gain during the supplementation period (primary outcome) in the tailored vs. standard fortification group: 27.01 ± 10.19 g/d vs. 25.84 ± 13.45 g/d, Preterm birth results in a high risk of mortality and is a cause of several morbidities, including extrauterine growth restriction [There are several modalities for fortifying HM. While standard breastmilk fortification is the most feasible strategy in a NICU, it does not account for the substantial variability in HM composition between mothers and between milk samples from the same individual [To our knowledge, this is the first randomized controlled trial to evaluate whether targeted HMF can optimize growth in infants born at a gestational age < 32 weeks using all three macronutrients in an Eastern European setting. The study protocol was approved by the local ethics committee and was published [