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Human milk derived fortifiers are associated with glucose, phosphorus, and calcium derangements

Journal of Perinatology (2024)Cite this article

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Abstract

Objective

In 2017, our Level IV NICU switched from providing bovine-derived (BOV-fort) to human milk-derived fortifiers (HM-fort) and donor human milk (DHM) to premature infants born ≤ 30 weeks or ≤1250 g. Following this change, providers anecdotally observed increased hypoglycemia, hypercalcemia, and hyperphosphatemia. This study investigated potential laboratory differences between infants fed Bovine vs. Human milk derived fortifier.

Methods

Lab measurements from 402 infants (232 BOV-fort, 170 HM-fort) born between 2015 and 2019 were compared between groups.

Results

The proportion of infants ever having a blood glucose ≤ 45 mg/dL (p < 0.0001) was higher in the HM-fort group. The proportion of infants ever experiencing a phosphorus > 8.0 mg/dL were higher in the HM-fort group (p < 0.0001). The proportion of infants ever experiencing calcium > 11.4 mg/dL was higher in the HM-Fort group (p = 0.019).

Conclusions

Provision of HM-Fort and DHM to extremely premature infants is associated with metabolic derangements.

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Fig. 1: Prevalence of metabolic derangements.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Funding

This project was supported by the University of Rochester CTSA award number UL1 TR002001 from the National Center for Advancing Translational Sciences of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Division of Neonatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

    Danielle Ackley, Carl D’Angio & Jeffrey Meyers

  2. Department of Pediatrics, Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

    Jiamin Yin

  3. Division of Breastfeeding & Lactation Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

    Bridget Young

Authors
  1. Danielle Ackley
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  2. Jiamin Yin
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  3. Carl D’Angio
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  4. Jeffrey Meyers
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  5. Bridget Young
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Contributions

DA and BY contributed to study conception and design, data collection, analysis and interpretation of results, and draft manuscript preparation. JY contributed to analysis and interpretation of results as well as draft manuscript preparation. JM and CD contributed to study conception, design and draft manuscript preparation. All authors reviewed the results and approved the final version of the manuscript.

Corresponding author

Correspondence to Danielle Ackley.

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Ackley, D., Yin, J., D’Angio, C. et al. Human milk derived fortifiers are associated with glucose, phosphorus, and calcium derangements. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01977-5

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