Human breast milk fortification with human milk fortifier vs preterm infant formula: A systematic review and meta-analysis.

This article systematically reviews and meta-analyzes randomized controlled trials (RCTs) comparing the safety and growth effects of breast milk fortification using preterm formula (PTF) versus human milk fortifier (HMF) in very low birth weight (VLBW) preterm infants. Based on six RCTs involving 434 infants, the analysis found no significant differences in weight, length, or head circumference growth velocities between PTF and HMF fortification. However, PTF-fortified breast milk was associated with a lower risk of necrotizing enterocolitis (NEC) and feeding intolerance, with similar rates of sepsis, mortality, and hospital length of stay compared to HMF. The overall certainty of evidence was very low due to study limitations and bias risks, indicating a need for larger, well-designed trials to confirm these findings, especially in resource-limited settings where HMF availability is constrained.