BREAST MILK FORTIFIER, powder, 1g, sachet
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BREAST-MILK FORTIFIER, powder
Breast-Milk Fortifier
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.