Fortifying human milk in preterm infants should be done how?

• A. Do not fortify human milk.
• B. Fortify with simple sugars only.
• C. Fortify using donor formula that is not individualized.
• D. Fortify to meet caloric and protein needs; adjust based on weight velocity.

Answer: (D)

Preterm infants have high caloric and protein needs to support rapid growth and organ development, so fortifying human milk is essential. The best approach is to fortify in a way that meets those needs and then tailor the amount based on how the baby is growing, specifically by weight gain velocity. Monitoring weight velocity lets clinicians adjust fortification to maintain adequate growth without overfeeding.

Not fortifying leaves the infant short of calories and protein. Fortifying with simple sugars only provides energy but not the protein and other nutrients necessary for growth. Using donor formula that isn’t individualized misses the infant’s specific needs and growth trajectory, which can lead to under- or over-fortification.