Human milk fortification strategies for improved in-hospital growth of preterm infants

Human milk is the preferred feed for preterm infants, yet it may need to be fortified for optimal growth and development. Standard fortification of human milk seldom meets the recommended intake of protein, leading to inadequate post-natal growth. This article aims to critically review different human milk fortification strategies with a focus on in-hospital growth of premature infants in resource-limited settings. Super, adjustable and target fortification are compared to standard fortification. Different growth outcome parameters limit comparability of findings, but super fortification and adjustable fortification present opportunities to explore. More uniform growth outcome assessment is recommended. Practical implementation and cost-effectiveness in the local setting need to be investigated.