Human Milk-Derived Fortifiers Are Linked with Feed Extension Due to Hypoglycemia in Infants <1250 G or <30 Weeks: a Matched Retrospective Chart Review.

Objective To investigate differences in hypoglycemia and extended feed prescriptions among premature infants provided bovine-derived human milk fortifiers (Bov-fort) with mother’s milk or formula vs human milk-derived human milk fortifiers (HM-fort) with mother’s milk or donor human milk. Study design This was a retrospective chart review ( n = 98). Infants receiving HM-fort were matched with infants receiving Bov-fort. Blood glucose values and feed orders were retrieved from the electronic medical record. Results Prevalence of ever having blood glucose <60 mg/dL was 39.1% in the HM-fort group vs. 23.9% in the Bov-fort group ( p = 0.09). Blood glucose ≤45 mg/dL occurred in 17.4% of HM-fort vs 4.3% in Bov-fort ( p = 0.07). Feeds were extended for any reason in 55% of HM-fort vs. 20% of Bov-fort ( p < 0.01). Feed extension due to hypoglycemia occurred in 24% of HM-fort vs. 0% of Bov-fort ( p < 0.01). Conclusion Predominately HM-based feeds are associated with feed extension due to hypoglycemia. Prospective research is warranted to elucidate underlying mechanisms.