1. Introduction
weight gain
REGRESSION, SECONDARY
Despite advances in neonatal nutrition, very preterm infants remain at increased risk of extrauterine growth faltering. This prospective study aimed to examine the effect of hindmilk, the milk at the end of a breast expression session, on growth and plasma fatty acids (FAs) of infants born <30 weeks’ gestation who had been on full enteral feeds for ≥2 weeks and had a weight gain of <15 g/kg/day despite optimizing energy and protein intakes. Weight and plasma FAs were assessed before and two weeks after feeding hindmilk. Growth anthropometrics were assessed weekly for four weeks. Paired t-tests and multiple linear regression were used for statistical analyses of data from 34 infants and their 29 mothers. There was a significant increase in weight gain in the two weeks after feeding hindmilk (MD 3.9, 95%CI 1.2–6.5 g/kg/day). Weight Z-scores were larger at two weeks (MD 0.61, 95%CI 0.02–1.20) and onwards. Head circumference Z-scores were larger at three weeks (MD 0.83, 95%CI 0.20–1.47) and onwards. Plasma linoleic acid (LA) and α-linolenic acid (ALA) increased after feeding hindmilk. In conclusion, hindmilk may improve weight and head growth and increase LA and ALA in very preterm infants with suboptimal growth. A large randomized controlled trial is required to examine and validate the potential benefits of hindmilk.Despite advances in neonatal nutrition, very preterm infants remain at increased risk of extrauterine growth faltering [Fat constitutes the main energy source in human milk and accounts for 40–50% of caloric intake [Breastmilk is also the main source of essential fatty acids (EFAs) in the postnatal period. EFAs are essential for brain development, visual functions, and growth [The primary aim of this study was to assess the effect of feeding hindmilk on the growth velocity of very preterm infants with suboptimal growth velocity. The secondary aim was to examine the impact of feeding hindmilk on infants’ plasma fatty acid profile. 