New research gives fortified mother’s milk a thumbs up for preterm babies’ growth

These facts were presented by Ekhard Ziegler,paediatrics professor and expert in nutrition of preterm infants,at University of Iowa’s Children Hospital,US,in Lucknow on Saturday.

Prof Ziegler was in the town to participate in a workshop on “Preterm Nutrition: Indian & Global Perspective”. Dr Amit Upadhyay,Head and Assistant Professor,Department of Pediatrics,LLRM Medical College,Meerut,also participated in the workshop.

Recently,the National Neonatal Forum has also come up with guidelines making fortification of milk essential for treatment of babies born with less than 1.5 kg of weight.

Dr Ziegler said the preterm babies are low weight and as their gastrointestinal tracts are not well developed,they cannot absorb nutrition. “It is a standard practice in the Europe and US to fortify the mother’s milk with fortifiers constituting protein and mineral supplements and then feed the preterm babies,” said Ziegler.

“Studies prove the protein requirement of a preterm baby is three times more than what the mother’s milk can provide. In the beginning,as the babies are unable to absorb more than a few drops of milk,intravenous nutrition is provided and milk drops are given to develop the GI tract of the child,” he said,adding that a preterm infant is released from the hospital only after it has gained a weight of up to 2200 to 2600 grammes.

On the other hand,in India,said Dr Upadhyay,due to poor patient-bed ratio,the preterm babies are generally released from the hospitals when they are between 1300 to 1500 grammes,if they are absorbing nutrition normally and do not have any other complications. However,agreed Dr Upadhyay,early release in these cases pose a risk of mortality in these kids as they do not get the required nutrition and follow-ups of such kids is poor especially if they come from poor economic background.

Talking to The Indian Express over the phone on the issue of fortification of mother’s milk for preterm babies below 1500 grammes in the country,Dr Umesh Vaidya,paediatrician at KEM Hospital,Pune said that till recently,India has not been seeing many low birth preterm babies surviving,a reason why the nutritional requirements of such babies have not been the focus area of neo-natologists in the country. However,as neonatal care improves in the country,now fortification of the mother’s milk for babies has come into focus.

“In our guidelines (of National Neonatal Forum) for management of low birth and preterm babies released recently,we have added this formula of fortifying mother’s milk before giving it to the preterm babies,” said Dr Vaidya,who was one of the writers of these guidelines.

“India has just one company manufacturing fortifiers as of now,that too of not superb standards. But now that the entire movement of fortifying mother’s milk has begun,we are trying to talk to the company which manufactures it and improve the quality of the fortifiers,” he said.