73 IGF-I and nutrition in preterm infants 4 case of growth restriction in formula-fed infants, intake was increased to 180 mL kg−1 day−1 and an additional 1.5 g of preterm starters formula was added per 100 mL formula (Nutrilon Nenatal Start, Nutricia, Wageningen, The Netherlands). In addition, protein fortifier and a fat emulsion could be added to the formula if poor growth persisted. Study Procedures All participants were admitted to the NICU of Amsterdam UMC, location VU University medical center within 24 h from birth. Infants in good clinical condition were discharged to step-down units in other hospitals at a PMA of 30 weeks and a weight of at least 1000 g. Obstetric data, clinical condition and intake up to 36 weeks PMA were collected from hospital records. Growth Growth was assessed weekly between birth and 36 weeks PMA. Weight was measured on an electronic scale to the nearest gram, length was measured on a length board to the nearest 0.1 cm, and occipital-frontal head circumference was measured with a nonstretchable measuring tape to the nearest 0.1 cm. The measurements were done by the nursing staff. Standard deviation scores (SDS) of weight, length and head circumferences were calculated according to Fenton (14). Intake Daily macronutrient intake was calculated from actual intake data obtained from hospital records. Own mother’s milk composition was based on reference values (15, 16) (Table 1). Donor human milk composition was based on analyses of the donor milk batches administered to the first 23 study participants. Table 1. Reference values used for the nutritional composition of human milk per 100 mL. Variables OMM OMM + BMF (4.4g/100mL) DHM DHM + BMF Energy (kcal) 68.5 83.8 60 75 Protein (g) 1.5 2.6 0.8 1.9 Protein/energy ratio (g/100 kcal) 2.2/100 1.3/100 Carbohydrates (g) 7.3 10.0 7.5 10.2 Fat (g) 3.3 3.3 2.9 2.9 BMF: Breast milk fortifier, DHM: donor human milk, OMM: own mother’s milk.
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