A Randomized, Controlled Study to Investigate How Bovine Colostrum Fortification of Human Milk Affects Bowel Habits in Preterm Infants (FortiColos Study)
Mother’s own milk is the optimal diet for neonates but if it is not available or an insufficient volume is achieved, donor human milk is considered the second-best choice. However, neither mother’s milk nor donor milk contains enough protein and minerals to support optimal growth in very preterm infants. Nutrient fortifiers are added to human milk to meet the nutritional needs to support optimal growth of very preterm infants, though these products are suspected to increase gut dysmotility. The clinical trial included 242 preterm infants (26-31 weeks of gestation) randomized to receive either BC (bovine colostrum) or CF (conventional fortifier) as a fortifier. As intake of fortifiers increased, stools became harder in both groups but less in BC infants (p < 0.05). The incidence of bowel gas restlessness increased with laxative treatments and days of fortification in both groups (p < 0.01), but laxatives were prescribed later in BC infants (p < 0.01). With advancing age, stomach appearance scores improved, but more so in BC infants (p < 0.01). Conclusions: Fortification of human milk with intact BC, targeting protein recommendations and growth rates, does not negatively affect very preterm infants but may induce softer stools, less adverse abdominal appearance, and less/later treatment with laxatives. In turn, this could improve the infant’s quality of life. From a bowel habit perspective, it appears safe to use BC as a novel fortifier for human milk to very preterm infants.