• Enfamil® Human Milk Fortifier Powder

Enfamil® Human Milk Fortifier Powder

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.

  • Product Features
      • Well tolerated
      • 1.1 g protein/4 packets
      • Added iron to reduce the need for additional iron supplementation
      • Includes fat and essential fatty acids
      • Low osmolality
  • Nutrients*
    • (4 Packets) Per 4 - 0.025 oz (0.71 g) Packets (14 Cal)
      Protein, g 1.1
      Fat, g 1
      Linoleic acid, mg 140
      Carbohydrate, g <0.4
      Water, g 0.09
      (Normal Dilution) Per 4 - 0.025 oz (0.71 g) Packets (14 Cal)
      Vitamins/Other Nutrients
      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
      Niacin, mcg 3000
      Folic acid (Folacin), mcg 25
      Pantothenic acid, mcg 730
      Biotin, mcg 2.7
      Vitamin C (Ascorbic acid), mg 12
      Choline, mg NA
      Inositol, mg NA
      (Normal Dilution) Per 4 - 0.025 oz (0.71 g) Packets (14 Cal)
      Minerals
      Calcium, mg 90
      Phosphorus, mg 50
      Magnesium, mg 1
      Iron, mg 1.44
      Zinc, mg 0.72
      Manganese, mcg 10
      Copper, mcg 44
      Iodine, mcg NA
      Selenium, mcg NA
      Sodium, mg 16
      Potassium, mg 29
      Chloride, mg 13

      * Product nutrient values and ingredients are subject to change. Please see product label for current information.

      NA = None Added

  • Nutrient Facts
    • 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
      Lactose-Free No
      Galactose-Free No

      † 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.

  • Product Form
    • Enfamil® Human Milk Fortifier Powder is available in powder.

    • Item #: 201418
      Description: Powder
      Unit Size: 0.71 g Foil Sachet
      Cal./Unit: 3.5
      Prod. Yield / Unit (fl oz): N/A
      Case: 200 units per case
      Reimbursement Code: 00087-201448

      HCPCS Code

  • Composition
    • 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.

  • Potential Allergens
    • Enfamil Human Milk Fortifier Powder contains milk and soy.

  • Preparations of Feedings
    • 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:

      1. 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.

      2. 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.

      3. Do not add Enfamil Human Milk Fortifier Powder to breast milk in a ratio greater than 1 packet/25 mL.

      4. 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.

      Powder Storage

      Store Enfamil Human Milk Fortifier powder at room temperature. Avoid freezing and excessive heat. Use by date on package.

      CAUTION

      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.

  • References
    • 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.