PP251 - LYOPHILIZED HUMAN MILK FORTIFICATION IN CHILDREN WITH CONGENITAL HEART DISEASE

PP251

LYOPHILIZED HUMAN MILK FORTIFICATION IN CHILDREN WITH CONGENITAL HEART DISEASE

A. Allfather^1,*, E. Finnan¹, P. M. Crowley², K. Mcdonough¹, K. I. Mills³

¹Boston Children's Hospital, Boston, United States, ²Gastroenterology, ³Cardiology, Boston Children's Hospital, Boston, United States

Rationale: Infants with congenital heart disease (CHD) are at high risk for malnutrition and often require fortified feeds to meet increased energy demands. While human milk is associated with improved feeding tolerance and lower rates of necrotizing enterocolitis (NEC), standard fortification relies on bovine-based products. Lyophilized human milk fortifier (FD-HMF) represents a novel strategy to maintain an exclusive human milk diet in this high-risk population.

Methods: We performed a retrospective case series of infants with CHD who received FD-HMF over a 9-month period at a single tertiary care center. Eligible patients included infants <18 months initiated on FD-HMF in the inpatient or outpatient setting. Demographic, clinical, and nutritional data were obtained from the electronic medical record. Feeding tolerance and growth were assessed.

Results: Sixteen infants were included with a median age of 123 days (IQR 93, 160).  Four infants were premature with a median gestational age of 38 1/7 weeks (IQR 36.8, 39.1). FD-HMF was initiated preoperatively in 2 infants, between staged procedures in 5, and postoperatively in the remainder. Baseline human milk analysis demonstrated median caloric density 23.4 kcal/oz (IQR 20.4, 24.7) and protein 0.24 g/oz (IQR 0.22, 0.26). Median maximum fortification was +6 kcal/oz (IQR 4, 6). At 1 month following FD-HMF initiation, median change in weight-for-age z-score was +0.33 (IQR 0.11, 0.58). Subjective feeding tolerance improved in 88% (14/16) of patients. No episodes of NEC were reported.

Conclusion: FD-HMF may be a safe and promising strategy to improve nutritional status and feeding tolerance in infants with CHD while preserving an exclusive human milk diet. Larger prospective studies are needed to evaluate effects on growth, objective feeding tolerance, and safety across inpatient and outpatient settings.

Disclosure of Interest: None declared