What is a breast milk fortifier?

A breast milk fortifier is a nutritional supplement to be added with human milk. It comes in a powdered form to be mixed with breast milk or donor milk. It contains extra calories, protein, some essential minerals (fortified with calcium and phosphorus) and other nutrients which help promote growth and bone development during the initial few weeks of life.

Why does my baby need a breast milk fortifier?

Your breast milk is the best source of nutrition for your baby however, babies who are born prematurely or have a low birth weight may not have had time to build up their natural stores of important proteins and vitamins. Therefore, for these babies breast milk alone may not provide enough energy and nutrients for achieving growth. These babies are usually given breast milk fortifier.

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Parent and Caregiver Information Sheet

Exclusive Human Milk Diet (EHMD) is defined as a diet in which 100% of the Proteins, Fats and Carbohydrates are derived solely from human milk resource.

Mothers Milk

Human donor Milk

Human milk-based fortifier

Parameters Cow's Milk-based Fortifier Human Milk-based Fortifier
Retains anti-bacterial properties of breast milk1
Immunoglobulins2
(Antibodies)
Human Milk Oligosaccharides2
(Prebiotics for gut health)
Alpha-Lactalbumin3
(High-quality whey protein)
Improved feed tolerence4
  • 1. Chan GM, et al. Breastfeed Med 2007 Dec;2(4):205-8.
  • 2. Data on file
  • 3. Nielsen CH, et al. Nutrients; 2020;12(1):245.
  • 4. Assad M, et al. J Perinatol 36, 216-220 (2016)
  • 5. Hampson G, et al. J BMC Pediatr 19, 337 (2019)

What are the types of breast milk fortifiers available?

Until recently, the only type of fortifiers available in the UK were made from cow’s milk. Now, fortifiers made from human milk are also available which offer unique benefits not available through conventional cow's milk-based fortifiers. Human milk-derived fortifiers retain the advantages of breast milk including Immunoglobulins and Human Milk Oligosaccharides, making sure your baby receives enough nutrients through the most natural way possible. Moreover, they also help adhere to EHMD which result in substantially improved outcomes for prematurity-related complications 5.

How is the breast milk fortifier used and for how long?

Breast milk fortifier will be prescribed by a doctor. To start with, a small amount will be measured and mixed with your breast milk or to the donor milk your baby is receiving. The fortified breast milk will be prepared by the staff caring for your baby and feeding will take place in the normal way. The duration of fortification will be decided by the team looking after your baby, based on growth markers such as weight gain, head circumference and length gain among others.

Did you know?

The term "Human Milk Fortifier" (HMF) is a generic name for a nutritional supplement that is added to mother's milk or donor milk to meet the dietary needs of premature babies in the neonatal intensive care unit (NICU). It is frequently assumed that because it is "Human Milk Fortifier" it must be made from human milk, which is not true.

WHO recommendations on type of fortifiers 1

VLBW* infants who fail to gain weight despite adequate breast-milk feeding should be given human-milk fortifiers, preferably those that are human milk based.

Protein source in type of fortifiers 2

Table - NeoKare
  • 2. At 150ml/kg/day with 6 sachets of fortifiers

HM : Human milk

HMDF : Human milk-derived fortifier

CMDF : Cow's milk-derived fortifier