SIROYS FM

HUMAN MILK FORTIFIER

A READY RECKONER
1. When to recommend?
In neonates with birth weight below 1800 grams (ESPGHAN 2009 guideline)
Agostoni C, Buonocore
G, Carnielli
VP, DeCurs M.
Enteral nutrient supply
forpreterminfants:commentary from the European Society for Paediatric Gastroenterology, Hepatology,
and Nutrion Commiee on Nutrion. J Pediatr Gastroenterol Nutr 2010; 50:8591

2. What are the benefits?

Improvements in weight gain (+2.33 g/kg/d; 95%CI 1.73, 2.93), linear growth (+0.12
cm/week; 95%CI 0.07, 0.18), and head growth (+0.12 cm/week; 95%CI 0.07, 0.16).
Kuschel CA, Harding JE. Mulcomponent forfied human milk for promong growth in preterm infants
(Cochrane Review). Cochrane Library 2004; 3.

Beer test scores in the forfied group by 2.2 points for the Bailey Mental
Development Index, by 2.4 points for the Psychomotor Development Index, and by
3.1 points for social maturity at 18 months.
Lucas A, Fewtrell MS, Morley R, et al. Randomized outcome trial of human milk forficaon and development
outcome in preterm infants. Am J Clin Nutr 1996; 64: 14251

3. At what age of the neonate HMF should be added?

HMF 1 sachet in 25 ml of expressed breast milk should be added when the neonate
starts accepng 100ml/kg of feeds.

4. How long the reconstuted EBM + HMF can be stored?

It can be stored for 8 hours at 2-80C

www.siroylifesciences.com

5. When should HMF be stopped?

If the baby is on direct breast feeds at the me of discharge, HMF forficaon is
usually disconnued as it interferes with direct breast feeds.
If baby is on expressed breast milk, then HMF should be connued ll baby
achieves its birth percenle on growth charts. Convenonally in such cases HMF is
connued ll 40 weeks.

6. What is the most important advantages of Siroys HMF?

a) Siroys HMF provides 1gm protein per 100 ml of milk and protein intake has
shown to have impact not only on short term growth but also on long term
neurological outcome.
b) It provides high iron content 1.44mg (4 sachets)
c) Osmolality is with in safe limits.
d) Vitamin D content 400IU (4 sachets)

7. Does use of HMF increase the risk of Necro zing enterocoli s?

Systemac review comparing infants fed unforfied and forfied HM did not show
any significantly increased risk of NEC in infants receiving Forfied Human Milk (RR
1.33, 95% CI 0.7 to 2.5)
Kreissl A, Zwiauer V, Repa A, Binder C, Haninger N, Jilma B, Berger A, Haiden N. Effect of
fortifiers and additional protein on the osmolarity of human milk: is it still safe for the premature
infant? J PediatrGastroenterolNutr. 2013;57(4):432-7

8. Use of HMF makes the treatment costly or cost eec ve?

Unlike the developed countries where the cost of HMF is prohibive, Siroys FM
comes with a reasonable cost and would help further cost cung by decreasing the
hospital stay.

www.siroylifesciences.com