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Table 1 Individualized Human Milk Fortification Methods [7]

From: Letter to the editor: clarifying some aspects and the terminology of individualized human milk fortification

HM Fortification Method Characteristics Advantages/Disadvantages
1. Adjustable (ADJ) HM Fortification BUN is monitorized twice weekly, cut-off levels of BUN are 10–16 mg/dl. If the level is less than 10 mg/dl extra protein is added to the standard fortification. Practical, not labor intensive
Monitors protein status of each infant
Safeguards also against excessive protein intake
Does not need expensive devices
Proven to be effective in optimizing growth and protein intake with a RCT.
A real individualization method taking into consideration each infant’s protein requirement
2. Targeted HM Fortification Macronutrient concentrations in HM are analyzed and based on the results milk is supplemented with extra protein and/or fat. Both protein and energy can be supplemented
Bedside analyzers are available but are expensive
May be labor intensive
More importantly the method supplements the milk according to the general recommendations, does not take into consideration that each individual infant’s requirement may be different