BREAST MILK FORTIFIER, powder, 1g, sachet

STD NFOSHMFO1--

Valid Article


Article is intended to be used with children (<12 years) ONLY.
13
Shelf life = length of time a product can remain active and effective. Short shelf life = shelf life = < 24 months
Thermosensitive codes are defined for storage and transportation temperature requirements of the products.

OC subscriptions: included in supply or field order tools (e.g. UniField)
SC subscriptions: included in supply or field tools
OC validations: approved for procurement and use by an OC for international or local orders specifying context and activity in Medical Standard Lists (MSL)

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BREAST MILK FORTIFIER, powder

Definition

Breast Milk Fortifiers (BFM) (also known as Human Milk Fortifiers) are designed to be added to breast milk. Breast-milk fortification provides the necessary nutrients and promotes rapid growth rate and bone mineralisation in low-birth-weight and premature neonates.

Breast milk is the ideal food for neonates. However, while its nutrient composition is ideal for full-term infants, it may lack sufficient proteins and minerals for low-birth-weight neonates, whose protein and mineral requirements are higher for growth.

BMF should be added to the meals of neonates who meet all of the following criteria:

  • birth weight is < 2000 g, AND
  • at least one week old, AND
  • receiving fluid requirements by enteral route, and at least partially by another method (cup/spoon feeding, double-channel gastric tube...), AND,
  • taking less than 15 g/kg/day for 3 consecutive days despite adequate breastfeeding.

When quantities of breast milk are insufficient, the priority should be to increase breast milk production.

Example: Nutrilon

Specifications

Technical specifications

Nutritional valuesper 100 g‌ powder

per 100 ml

after reconstitution at 4%

Energy (kj)147565
Energy (kcal)34715
Proteins25.21.1
- Caseins (g)12.50.6
- Serum proteins (g)12.50.6
Carbohydrates62.22.7
- Sugar (g)5.50.2
- Lactose (g)0.40
- Maltodextrines (g)51.52.3
Lipids00
- Saturated fatty acids (g)00
Fibres (g)00
Minerals
Sodium (mg)80335
Potassium (mg)52823
Chloride (mg)57325
Calcium (mg)149166
Phosphorus (mg)87238
Magnesium (mg)1155
Zinc (mg)140,61
Copper (μg)80335
Manganese (μg)1838,1
Selenium (μg)391,7
Iodine (μg)25211
Vitamins
Retinol (Vit A) (μg-RE)5275232
Cholecalciferol (Vit D) (μg)1155
Tocopherol (Vit E) (mg-α-TE)602,6
Phylloquinone (Vit K) (μg)1446,4
Ascorbic ac. (Vit C) (mg)27512
Thiamin (Vit B1) (μg)3005132
Riboflavin (Vit B2) (μg)3922173
Niacin (Vit B3)532,3
Pyridoxine (Vit B6) (μg)2523111
Folate (Vit B9) (μg)68830
Riboflavin (Vit B2) (μg)4,60,2
Biotin (Vit B7) (μg)572,5
Pantothenic acid (μg)17 201757

Cf Product specifications sheet ref MSF-NFOS-PSS12, for more detailed specifications on this product (raw material...)

Packaging & Labelling

Primary and secondary packaging must protect the hygienic and nutritional qualities of the product during transport, handling, storage under MSF field conditions.

  • Primary packaging (unit packaging): 1 gr sachet, box of 50 sachets

For more information on packaging labelling, refer to the CHECKLIST CONTROL UPON RECEIPT specialised food.

Instructions for use

Instructions for fortification of expressed breast milk

  • Always follow the instructions provided on the product packaging.
  • Check the amount of breast milk required, and assist the mother in expressing the required amount.
  • Fortification must be introduced gradually:
    • Once the neonate reaches and tolerates 80 to 100 ml / kg / day of expressed breast milk, begin fortification with a 2% fortifier at each feed.
    • If well tolerated after 48 hours, increase to a 4% fortifier at each feed.
    • Gradually increase the quantity of 4% fortified milk according to the infant's tolerance, up to 160-180 ml/kg/day
  • Refer to the table bellow to determine the amount of BMF to add to the expressed milk accordingly.

Quantity of

expressed breast milk

Quantity to add

(for a 2% fortification

Quantity to add

(for a 4% fortification)

25 ml - 49 ml0.5 gram1 gram
50 ml - 74 ml1 gram2 grams
75 ml - 99 ml1.5 gram3 grams
100 ml - 124 ml2 grams4 grams
125 ml - 149 ml2.5 grams5 grams
150 ml - 175 ml*3 grams6 grams

* if more than 175 ml, add the fortification accordingly.

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Storage

Follow the instructions for storage written on packaging, and the procedure QA-NFOS-SOP3 "Storage of specialised food (NFOS).

For procedures related to Quality Control, refer to Preliminary remarks on specialised food.

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