From: DoMINO: Donor milk for improved neurodevelopmental outcomes
 | Supplement to MOM | Supplement to MOM |
---|---|---|
 | Pasteurized Human Donor Milk | Preterm Formula* |
Similac Special Care 20 or 24Â kcal/ oz [3.0Â g protein/100Â kcal] [Abbott Laboratories] or | ||
Enfamil Premature Formula 20 or 24Â kcal/oz [3.0Â g protein/100Â kcal] [Mead Johnson Nutritionals] | ||
Initiation of enteral feeding | Day 1-7 | Day 1-7 |
Volume of feeding at initiation | 10-20 ml/kg/d (hold volume for 3-5 days) | 10-20 ml/kg/d (hold volume for 3–5 days) |
Rate of feed advancement | 10-25Â ml/kg/day | 10-25Â ml/kg/day |
Fortification to commence at >120 ml/kg/day using milk pumped > 7 days after parturition+ | Human milk fortifier | Not Applicable |
Enfamil Human Milk Fortifier, [Mead Johnson Nutritionals] or | ||
Similac Human Milk Fortifier, [Abbott Laboratories] | ||
Volume | 140-200 ml/kg/d to achieve a weight gain of > 15 g/kg/day | 140-200 ml/kg/d to achieve a weight gain of > 15 g/kg/day |
Minimum protein dose to be provided once (or up to 3Â days after) volume reaches >150Â ml/kg/d | 3.0Â g/kg/d** | 3.0Â g/kg/d** |
At 24 kcal/oz and weight gain < 15 g/kg/d for 3–7 days | Concentrate feeding using a multi-nutrient modular to 26–27 kcal/oz | Modular to 26–27 kcal/oz |
At 27 kcal/oz and weight gain < 15 g/kg/d for 3–7 days | Concentrate feeding using a multi-nutrient modular to 30 kcal/oz | Concentrate feeding using a multinutrient modular to 30 kcal/oz |
At 30 kcal/oz and weight gain < 15 g/kg/d for 3–7 days | Remove from feeding protocol | Remove from feeding protocol |