@article{WANG2026, 
author = {Yun-He WANG and Yi YAO and Yun-Qian CHI and Zi-Han ZHANG and Yi-Yang LIU and Feng-Xin YI and Peng-Yuan WANG and Wei HAO},
title = {Post-discharge fortified human milk feeding in preterm infants with moderate-to-high nutritional risk: a retrospective cohort study},
year = {2026},
journal = {Chinese Journal of Contemporary Pediatrics},
volume = {28},
number = {10},
pages = {1218-1225},
keywords = {Fortified human milk, Nutritional risk stratification, Catch-up growth, Neuropsychological development, Preterm infant},
url = {https://www.sciopen.com/article/10.7499/j.issn.1008-8830.2508012},
doi = {10.7499/j.issn.1008-8830.2508012},
abstract = {ObjectiveTo investigate the effects of post-discharge fortified human milk feeding on growth, common complications, and neuropsychological development in preterm infants with moderate-to-high nutritional risk.MethodsClinical data were retrospectively collected from 320 preterm infants with moderate-to-high nutritional risk who were discharged from the Department of Neonatology, Provincial Hospital Affiliated to Shandong First Medical University between January 2021 and December 2023 and completed a 6-month follow-up. Infants were classified into four groups by nutritional risk level and feeding method: moderate-risk fortified human milk, moderate-risk formula, high-risk fortified human milk, and high-risk formula. Comparisons were conducted between fortified human milk and formula within the same risk level, and between moderate- and high-risk groups within the same feeding method.ResultsWithin the same feeding method, gestational age at birth and birth weight differed significantly between moderate- and high-risk infants (P < 0.001). Within the same nutritional risk level, no significant differences were found between fortified human milk and formula groups in gestational age at birth and birth weight (P>0.05). In the fortified human milk groups, corrected gestational age at discharge differed significantly between moderate- and high-risk infants (P < 0.05). No significant differences were noted among the four groups in discharge weight, length, or head circumference (P>0.05). Analysis of covariance, adjusting for discharge weight, length, head circumference, and corrected gestational age at discharge, showed no significant differences among the four groups during the 6-month follow-up in growth velocities of weight, length, or head circumference, nor in hemoglobin, 25-hydroxyvitamin D, or alkaline phosphatase measured at 1, 3, and 5 months (P>0.05). Multivariable logistic regression indicated that fortified human milk feeding did not increase the risk of infection (OR=0.66, 95%CI: 0.40-1.08, P=0.097) or feeding intolerance (OR=0.70, 95%CI: 0.45-1.08, P=0.107). At 6 months' corrected age, mental, motor, and behavioral scores did not differ significantly among groups (P>0.05).ConclusionsIn preterm infants at moderate-to-high nutritional risk, postdischarge fortified human milk feeding does not increase the risk of infection or feeding intolerance, does not differ significantly from formula feeding in short-term catch-up growth or neuropsychological development, and appears clinically feasible and safe.}
}