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About human milk fortifier
Human milk fortifier (or breast milk fortifier) is a powder added to breast milk to boost a baby’s nutrition. Some parents think of fortifier as a ‘protein shake’ for their baby.
The main nutrients in the fortifier powder are:
- some proteins (for tissue and brain growth)
- some carbohydrates (for energy and growth)
- calcium
- phosphate (for bone strength)
- some micronutrients (vitamins, minerals and salts) which are needed, for example for bone health.
These nutrients are essential for your premature baby to grow well.
We do not use fortifier long term.
We generally stop fortifier around the baby’s estimated due date. Your dietitian will monitor your baby’s growth and will offer guidance.
Which babies are offered fortifier?
We usually offer human milk fortifier to low weight premature babies or premature babies who are not gaining as much weight as expected. This may be due to medical complications such as chronic lung disease, cardiac (heart) problems or immature kidneys. Using fortifier is part of routine care in the neonatal unit.
Why we have suggested fortifier to you
Premature babies have greater nutritional needs than term babies. This is because they have missed out on nutrients they would have received through your placenta during the last term of pregnancy.
Breast milk alone does not have enough protein and nutrients to meet the extra nutritional needs of a premature baby. The fortifier covers this gap. It means premature babies can receive full nutrition in a volume of breast milk that is manageable for them.
Important
We have not suggested breast milk fortifier because your milk is ‘not good enough’.
Giving your baby fortifier does not mean your baby will stop breastfeeding.
Breast milk is the absolute best food for your baby. It is easily digested and helps your baby’s immune system to fight infections, particularly a serious bowel infection called NEC.
The amount of fortifier we suggest
To start with, we will weigh the fortifier exactly for each feed. We will adjust it to the volumes of breast milk taken by your baby.
As your baby gets closer to discharge and breastfeeding becomes more established, we will adjust how much fortifier to give and how to give it.
We may use one or two sachets added to a tiny amount of your expressed breast milk and give this to your baby as concentrate, just before or after a breastfeed. This routine will make it easier for you to give fortifier when you take your baby home.
We will also discuss with you the different ways to give the fortifier, for example via a syringe or with a bottle or through a feeding tube.
Are there side effects?
Neonatal units have used fortifier for the past 20 years. Babies usually tolerate it well.
On rare occasions, a baby may vomit, pass more stools (poo) or get more constipated. (This often happens even without fortifier, as the gut of premature babies is still immature.)
There is no evidence linking fortifier to an increased risk of the bowel infection known as NEC.
There is no evidence linking fortifier to the risk of cow’s milk allergy (sometimes called ‘intolerance’). Fortifier powder is made of dried cow’s milk and the milk proteins are already broken down as an extra safety factor.
Your neonatal team will monitor your baby closely when fortifier is introduced. This is to ensure your baby tolerates the fortifier.
More information
Contact information
Kingston Hospital Neonatal Unit Reception, Monday to Friday 9 am to 4 pm
Telephone: