Beth Godden1, Carmel T Collins2, Cathie Hilditch1,2,3, Gemma McLeod4,5, Amy Keir1,2,3,6. 1. Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia. 2. SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. 3. Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia. 4. Centre for Neonatal Research and Education, University of Western Australia, Perth, Western Australia, Australia. 5. Women and Newborn Health Service, King Edward Memorial and Princess Margaret Hospitals, Perth, Western Australia, Australia. 6. Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
Abstract
AIM: This evidence-based review aims to answer the following structured clinical question: In preterm infants <37 weeks' gestation (patient), does early fortification of breast milk (intervention) compared to late fortification (control) improve growth outcomes at the time of discharge or affect length of hospital stay (outcome)? METHODS: MEDLINE, Embase, Maternity and Infant Care Database and Evidence-Based Medicine Reviews were searched for articles published from 2000 onwards that were relevant to the structured clinical question. The National Institute for Health and Care Excellence, National Health and Medical Research Council, Agency for Healthcare Research and Quality, National Institute of Health and Turning Research into Practice databases were also searched, and reference lists of relevant articles were reviewed. RESULTS: A total of 167 articles, after removal of duplicates, were found and screened by title and abstract. Five full-text articles were ultimately included in the review. CONCLUSIONS: The results of this review suggest that early fortification is safe and well tolerated. However, earlier fortification has not been shown to have a significant impact on growth outcomes at time of discharge or length of stay. More research is required to determine if early fortification of breast milk may have benefits regarding longer-term growth and neurodevelopmental outcomes.
AIM: This evidence-based review aims to answer the following structured clinical question: In preterm infants <37 weeks' gestation (patient), does early fortification of breast milk (intervention) compared to late fortification (control) improve growth outcomes at the time of discharge or affect length of hospital stay (outcome)? METHODS: MEDLINE, Embase, Maternity and Infant Care Database and Evidence-Based Medicine Reviews were searched for articles published from 2000 onwards that were relevant to the structured clinical question. The National Institute for Health and Care Excellence, National Health and Medical Research Council, Agency for Healthcare Research and Quality, National Institute of Health and Turning Research into Practice databases were also searched, and reference lists of relevant articles were reviewed. RESULTS: A total of 167 articles, after removal of duplicates, were found and screened by title and abstract. Five full-text articles were ultimately included in the review. CONCLUSIONS: The results of this review suggest that early fortification is safe and well tolerated. However, earlier fortification has not been shown to have a significant impact on growth outcomes at time of discharge or length of stay. More research is required to determine if early fortification of breast milk may have benefits regarding longer-term growth and neurodevelopmental outcomes.