Doctors in Southampton have found an eight-week nutrient supplement for breastfeeding mums can help prevent weight loss and boost the growth of premature babies after they leave hospital.
Almost half (45%) of babies born prematurely – before 37 weeks – suffer from growth failure due to additional dietary requirements which cannot be met through breastfeeding alone.
Currently it is standard practice across the UK is to provide exclusively breastfed preterm babies with a protein and mineral-packed supplement, known as breast milk fortifier, during their time on neonatal units to complement mothers’ breast milk while it is delivered via a nasogastric tube.
However, this is usually stopped prior to discharge from hospital when babies transition to oral breast milk feeds and, as breast milk fortifier supplements are not prescribed by GPs, the additional nutrients they need are largely obtained from bottle-fed formula.
This, though, can affect the confidence of mothers to breastfeed and result in them choosing not to continue.
Preventing a dip in weight
“Preterm infants are so vulnerable and breastfeeding is encouraged to best support premature babies’ needs but breast milk alone doesn’t always meet their increased dietary requirements,” said Dr Luise Marino (below), clinical academic paediatric dietitian at Southampton Children’s Hospital.
Breastmilk fortifier contains extra protein and minerals such as phosphorus and calcium to promote bone growth, but it is currently stopped before premature babies are discharged home. As it is not available from GPs, this can lead to a reduction in growth at a crucial time in their development.
Dr Marino, consultant neonatologists Dr Mark Johnson and Dr Freya Pearson and dietitian Carol Fudge looked at the effects of supplying the supplement to 32 mums upon discharge for use at home for eight weeks.
They recommended that four sachets of milk fortifier were added to 40 millilitres of expressed breast milk, with five millilitres administered orally before each breastfeed or eight times per day.
This provided an additional 191 kcal, six grams protein, 111 milligrams phosphorus and 192 milligrams calcium per day.
The quality improvement study, published online by the journal Archives of Disease in Childhood, found use of the fortifier after leaving hospital prevented a dip in babies’ weight and resulted in better growth at eight weeks and a year.
Protecting breastfeeding
Parents who took part in a questionnaire about the study were positive about the use of breast milk fortifier at home, finding it easy to do. They also reported feeling less worried about the growth of their babies, with mothers saying it helped boost confidence in their ability to breastfeed.
Dr Marino added: "In this small group of infants, this method appeared to improve growth while also supporting, promoting and protecting breastfeeding in this vulnerable population group."
Due to the success of the study at University Hospital Southampton NHS Foundation Trust, the researchers are now looking to run a larger scale study at sites across the UK.