Managing slow growth in preterm infants fed on human milk

The benefits of human milk for the preterm infant are well documented. However, after the first 2–3 weeks following delivery, the nutrient content in human milk may be insufficient to promote growth in the rapidly growing preterm infant. The challenge for the neonatal team is to develop clinical strategies that support the use of human milk and the establishment of breastfeeding, while supporting infant weight gain and growth. A range of clinical strategies are required to monitor growth and manage sub-optimal growth. Over 50% of the energy babies receive from mature breast milk is from lipids. Hence it is very important to minimise fat loss during milk collection, handling and storage while giving expressed breast milk to maximise growth. Once breastfeeding has been established an assessment should be performed to ensure that attachment and positioning is optimal and that feeding care plans are in place, to ensure infant growth does not falter following discharge from hospital.