Nutritional supplement to be added to expressed breast milk for premature or low-birth-weight infants
Last Updated: Tuesday, July 22, 2014
Indication: Enfamil Human Milk Fortifier Powder is to be added to expressed breast milk for feeding premature or low-birth-weight infants. It provides enriched nutrition needed by these special babies while still allowing them to receive their mother's milk. Enfamil Human Milk Fortifier Powder is milk-based and, when mixed with mother's milk, increases the levels of protein, energy, calcium, phosphorus and other nutrients, producing a diet more suited to the nutritional needs of the rapidly growing premature infant.
Enfamil Human Milk Fortifier Powder was specifically designed to be used as a supplement to be added to mother's milk collected after 2 weeks postpartum.
|(4 Packets)||Per 4 - 0.025 oz (0.71 g) Packets (14 Cal)|
|Linoleic acid, mg||140|
|(Normal Dilution)||Per 4 - 0.025 oz (0.71 g) Packets (14 Cal)|
|Vitamin A, IU||950|
|Vitamin D, IU||150|
|Vitamin E, IU||4.6|
|Vitamin K, mcg||4.4|
|Thiamin (Vitamin B1), mcg||150|
|Riboflavin (Vitamin B2), mcg||220|
|Vitamin B6, mcg||115|
|Vitamin B12, mcg||0.18|
|Folic acid (Folacin), mcg||25|
|Pantothenic acid, mcg||730|
|Vitamin C (Ascorbic acid), mg||12|
|(Normal Dilution)||Per 4 - 0.025 oz (0.71 g) Packets (14 Cal)|
* Product nutrient values and ingredients are subject to change. Please see product label for current information.
NA = None Added
|Nutrient Density||Per 4 packets (14 Cal)|
|Protein (% Calories)||32|
|Fat (% Calories)||62|
|Carbohydrate (% Calories)||6|
|Potential Renal Solute Load (mOsm)1||70 per 100 Calories|
|Potential Renal Solute Load (mOsm)1||9.8 per 4 packets†|
|Osmolality (mOsm/kg water)‡||+35|
|Osmolarity (mOsm/L)‡||Not available|
† 24 mOsm/102mL when 4 packets added to 100 mL preterm human milk. ‡ When added to human milk as recommended, EHMF increases osmolality by approximately 35 mOsm/kg water.
Enfamil® Human Milk Fortifier Powder is available in powder.
Item #: 201418
Unit Size: 0.71 g Foil Sachet
Prod. Yield / Unit (fl oz): N/A
Case: 200 units per case
Reimbursement Code: 00087-201448
Ingredients: Powder: Medium-chain triglycerides (MCT) oil, milk protein isolate, whey protein isolate hydrolysate, soybean oil, calcium phosphate, calcium glycerophosphate, calcium gluconate and less than 2%: corn syrup solids, soy lecithin, vitamin A palmitate, vitamin D3, vitamin E acetate, vitamin K1, thiamin hydrochloride, riboflavin, vitamin B6 hydrochloride, vitamin B12, niacinamide, folic acid, calcium pantothenate, biotin, ascorbic acid, magnesium phosphate, potassium phosphate, ferrous sulfate, zinc sulfate, cupric sulfate, sodium citrate, potassium chloride, potassium citrate.
Enfamil Human Milk Fortifier Powder contains milk and soy.
The baby’s health depends on carefully following these instructions. Use only as directed by a medical professional. Improper hygiene, preparation, dilution, use or storage may result in severe harm. Although this powder is formulated for premature infants, nutritional powders are not sterile and should not be fed to premature infants or infants who might have immune problems unless directed and supervised by a doctor.
Follow hospital rules for the safe handling of human milk.
To aid mixing, agitate the human milk well. Pour the desired amount into a sterile container and warm to feeding temperature.
Add the powder to the breast milk according to the following chart:
|Additional Calories Desired||Breast Milk||Enfamil® Human Milk Fortifier Powder|
|2 Calories/fl oz||50 mL||1 packet|
|4 Calories/fl oz||25 mL||1 packet|
Failure to follow these instructions could result in severe harm. Once prepared, fortified breast milk can spoil quickly. Either feed fortified human milk immediately or cover and store in refrigerator at 35°-40°F (2°-4°C) for no longer than 24 hours. Agitate before each use.
For tube feeding: Once fortified human milk is prepared it can safely remain at room temperature for 4 hours2. The American Dietetic Association recommends a hang time for fortified breast milk of no longer than 4 hours at room temperature (25°C/77°F)3.
For bottle feeding: Pour only the amount of fortified human milk to be fed into a feeding container and feed immediately. Do not use fortified human milk if it is unrefrigerated for more than a total of 2 hours. After feeding begins, do not refrigerate feeding bottle. You must use within 1 hour or discard.
Suggestions When Using This Product:
Monitor and regularly assess blood levels such as serum calcium, sodium, urea nitrogen, albumin, and others. In case of an elevated level, reduce the amount of Enfamil® Human Milk Fortifier Powder used to supplement breast milk. In case of deficiency, additional supplementation with the deficient nutrient may be indicated.
Do not administer other nutrient supplements in addition to Enfamil Human Milk Fortifier Powder unless appropriate tests indicate a need for further supplementation with a particular nutrient.
Do not add Enfamil Human Milk Fortifier Powder to breast milk in a ratio greater than 1 packet/25 mL.
Preterm breast milk collected less than 2 weeks postpartum is particularly rich in nutrients, so fortification with Enfamil Human Milk Fortifier Powderis generally not required.
If more than 25 packets daily are used, the infant should be monitored for evidence of excessive vitamins A and D intake.
Store Enfamil Human Milk Fortifier powder at room temperature. Avoid freezing and excessive heat. Use by date on package.
Not nutritionally complete. To be used only under the supervision of a physician. Neither expressed human milk nor nutritional powders are sterile.
WARNING: Do not use a microwave oven to warm fortified breast milk. Serious burns may result.
Use only as directed. Improper dilution, preparation, handling, or storage may be harmful.
Regarding use in extremely low-birth-weight infants (ELBW–1 kg or less): Hypercalcemia has been reported in some of these infants on full enteral feeds of mothers’ milk supplemented with human milk fortifiers.
1. Fomon SJ, Ziegler EE. Renal solute load and potential renal solute in infancy. J Pediatr. 1999;134:11-14.
2. Telang S, Berseth CL, Ferguson PW, et al. Fortifying fresh human milk with commercial powdered milk fortifiers does not affect bacterial growth during 6 hours at room temperature. J Am Diet Assoc 2005;105:1567-1572.
3. American Dietetic Association. Robbins ST, Beker LT, eds. Infant Feedings: Guidelines for Preparation of Formula and Breastmilk in Health Care Facilities. Chicago, Ill: American Dietetic Association; 2004:91.