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NICU dietitian: Why I recommend 100% human milk diet

As a dietitian in the neonatal intensive care unit (NICU), I’ve seen the importance of nutrition in the outcomes of babies born prematurely. Premature babies, especially those born under 1250 grams, are incredibly fragile and at risk for poor health outcomes, such as mortality, necrotizing enterocolitis (NEC), late-onset sepsis, bronchopulmonary dysplasia, and retinopathy of prematurity. Over and over again, nutrition has been shown to play a significant role in minimizing these potential complications.1

My goals in the NICU are to understand what is best for each and every baby’s nutritional needs in order to optimize growth, improve feeding tolerance, and enhance neurocognitive development. Premature babies not only need to gain weight, but they also need to lay down muscle and lean body mass and build bone density. Human milk is the best feeding option to enable them to meet their needs, but when infants are born too early, mother’s milk usually doesn’t offer enough micronutrients, calories, and protein to promote the kind of growth these babies require to thrive and go home. This is when a fortifier is necessary to supplement mom’s milk or donor’s milk.

Fortifiers that are made with cow milk protein can be difficult for babies under 6 months to digest, let alone for babies born prematurely with an underdeveloped digestive system. Prolacta makes the only 100% human milk fortifier for premature infants born weighing < 1250 grams and I’ve seen the benefits of using Prolacta in the NICU first hand. Studies have shown that for extremely premature infants weighing between 500 and 1250 grams at birth, a 100% human milk diet that includes Prolact+ H2MF fortifier improves health outcomes, when compared to a diet that includes a cow milk-based fortifier or a cow milk-based preterm formula.