Nutrition Discharge Planning Instructions

Feeding Considerations for the Human Milk-Fed Preterm Infant Ready for Discharge

Decisions regarding what to feed the human milk-fed preterm infant after discharge should be individualized to support optimal growth through the first 12 months of life.4 Nutrition risk factors can be found on the opposite side of the form.

Options for nutrient dense feedings for the preterm infant post discharge (at 120 Cal/kg/d)

Human Milk / Abbott Nutrition Product

(Daily average, Cal/fl oz)

 Protein (g/kg/d)      Calcium (mg/kg/d)       Phosphorus (mg/kg/d)     
Nutritional Recommendation5 for infants with no nutritional deficits* 2.5 - 3.1
70 - 140

35 - 90

HM alternated with NeoSure RTF (21) 2.5 85

50

HM alternated with HM + SHMF Powder (22)

2.3

129

74

HM alternated with HM + SHMF HP CL (22) 2.9 122

67

HM alternated with Similac® Special Care® 24 RTF (22)

2.7

136

76

HM + 60 mL/d Similac® Special Care® 30 “booster”

2.1

84

47

Unfortified Human Milk Complications Include:6

  • Slow growth 
  • Body composition changes 
  • Low bone mineral accretion

Human Milk enriched with Preterm Discharge Formula Powder:

  • Regimen is a popular option, but, does not meet minimal nutrient recommendations

Considerations for discontinuing human milk fortification and/or supplementation include:6

  • Correction of extrauterine growth restriction 
  • Normalization of biochemical indices 
  • Attainment of term-corrected age 
  • Passage of 12 weeks

Infants requiring human milk fortification or Similac Special Care after hospital discharge, are at high nutrition risk and would likely benefit from transition to preterm discharge formula (i.e. Similac NeoSure).1,2

Similac NeoSure supports excellent growth in premature babies, better gains in weight, length and head circumference when compared to premature babies fed term infant formulas.3

Feedings adapted from Groh-Wargo and Thompson, 2014. Data generated from WebNova Nutrition Calculator; Abbott Nutrition; November 2017, November 2019.

* Infants who have accumulated nutritional deficits (typically VLBW infants and especially ELBW infants) have nutritional needs which exceed the intake recommendations above).

According to the AAP, “Strong consideration should be given to fortification of human milk for a minimum of 12 weeks for those infants who weigh less than 1250 g at birth and/or have incurred intrauterine or extrauterine growth restriction, because they represent the highest nutritional risk categories.”4

† Abbott Nutrition data on calorically dense feedings is limited. Hypocaloric and hypercaloric formulas should be used under the direction of a health care professional. 

References: 1.Groh-Wargo S et al. Body composition in preterm infants who are fed long-chain polyunsaturated fatty acids: a prospective, randomized controlled trial. Pediatr Res. 2005;57:712-718. 2. O’Connor DL et al. Growth and development in preterm infants fed long-chain polyunsaturated fatty acids: a prospective, randomized controlled trial. Pediatrics. 2001;108:359-371. 3. Carver JD, Wu PY, Hall RT, et al. Growth of preterm infants fed nutrient-enriched or term formula after hospital discharge. Pediatrics, 2001; 107: 683-689. 4. American Academy of Pediatrics Committee on Nutrition. Nutritional Needs of the Preterm Infant. In: Kleinman RE, Greer FR, eds. Pediatric Nutrition. 7th ed. Elk Grove Village, IL: American Academy of Pediatrics;2014:109. 5. Lapillonne A, O’Connor DL, Wang D, et al. Nutritional recommendations for the late-preterm infant and the preterm infant after hospital discharge. J Pediatr. 2013;162:S90-100. 6. Groh-Wargo S, Thompson M. Managing the human-milk-fed, preterm, VLBW infant at NICU discharge: the sprinkles dilemma. ICAN. 2014;6:262-269.