BREAST MILK FORTIFIER, powder, 1g, sachet
Valid Article
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 values | per 100 g powder | per 100 ml after reconstitution at 4% |
Energy (kj) | 1475 | 65 |
Energy (kcal) | 347 | 15 |
Proteins | 25.2 | 1.1 |
- Caseins (g) | 12.5 | 0.6 |
- Serum proteins (g) | 12.5 | 0.6 |
Carbohydrates | 62.2 | 2.7 |
- Sugar (g) | 5.5 | 0.2 |
- Lactose (g) | 0.4 | 0 |
- Maltodextrines (g) | 51.5 | 2.3 |
Lipids | 0 | 0 |
- Saturated fatty acids (g) | 0 | 0 |
Fibres (g) | 0 | 0 |
Minerals | ||
Sodium (mg) | 803 | 35 |
Potassium (mg) | 528 | 23 |
Chloride (mg) | 573 | 25 |
Calcium (mg) | 1491 | 66 |
Phosphorus (mg) | 872 | 38 |
Magnesium (mg) | 115 | 5 |
Zinc (mg) | 14 | 0,61 |
Copper (μg) | 803 | 35 |
Manganese (μg) | 183 | 8,1 |
Selenium (μg) | 39 | 1,7 |
Iodine (μg) | 252 | 11 |
Vitamins | ||
Retinol (Vit A) (μg-RE) | 5275 | 232 |
Cholecalciferol (Vit D) (μg) | 115 | 5 |
Tocopherol (Vit E) (mg-α-TE) | 60 | 2,6 |
Phylloquinone (Vit K) (μg) | 144 | 6,4 |
Ascorbic ac. (Vit C) (mg) | 275 | 12 |
Thiamin (Vit B1) (μg) | 3005 | 132 |
Riboflavin (Vit B2) (μg) | 3922 | 173 |
Niacin (Vit B3) | 53 | 2,3 |
Pyridoxine (Vit B6) (μg) | 2523 | 111 |
Folate (Vit B9) (μg) | 688 | 30 |
Riboflavin (Vit B2) (μg) | 4,6 | 0,2 |
Biotin (Vit B7) (μg) | 57 | 2,5 |
Pantothenic acid (μg) | 17 201 | 757 |
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 ml | 0.5 gram | 1 gram |
50 ml - 74 ml | 1 gram | 2 grams |
75 ml - 99 ml | 1.5 gram | 3 grams |
100 ml - 124 ml | 2 grams | 4 grams |
125 ml - 149 ml | 2.5 grams | 5 grams |
150 ml - 175 ml* | 3 grams | 6 grams |
* if more than 175 ml, add the fortification accordingly.
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.