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

Danielle Ackley; Jiamin Yin; Carl D'Angio; Jeffrey Meyers; Bridget Young

doi:10.1038/s41372-024-01977-5

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

J Perinatol. 2024 Apr 24. doi: 10.1038/s41372-024-01977-5. Online ahead of print.

Authors

Danielle Ackley¹, Jiamin Yin², Carl D'Angio³, Jeffrey Meyers³, Bridget Young⁴

Affiliations

¹ Division of Neonatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. danielle_ackley@urmc.rochester.edu.
² Department of Pediatrics, Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
³ Division of Neonatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
⁴ Division of Breastfeeding & Lactation Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.

PMID: 38658693
DOI: 10.1038/s41372-024-01977-5

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.