Breast milk fortification: Effect on gastric emptying

Abstract

Aim. To determine whether a widely used fortifier affects gastric emptying in very low birth weight infants and whether the amount of fortifier added to breast milk makes a difference with regard to gastric emptying.

Methods. The study hypothesis was tested in a balanced crossover design. Gastric emptying was determined in the same infant on the same day with each of the three test feedings (unfortified breast milk, half-fortified breast milk, and fully fortified breast milk) in random order. The antral cross-sectional area (ACSA) was measured by B-mode ultrasonography (US) and the feeding was given. The ACSA was determined again immediately after feeding was completed, and was then determined at 10-min intervals until the pre-feeding value was reached.

Results. The average half-emptying time was 49 ± 23 min with breast milk, 54 ± 29 min with half-fortified breast milk, and 65 ± 36 min with fully fortified breast milk. The differences between feeding groups were not statistically significant.

Conclusion. Fortification of breast milk does not play a clinically significant role in causing feeding intolerance in preterm babies when recommended concentrations of fortifier are used.

Keywords:

• Fortification
• feeding intolerance
• gastric emptying
• preterm infant