[Feeding very small premature infants with concentrated breast milk].

The use of concentrated breast milk was prospectively studied in 26 very small premature babies with a birth weight of 1,010-1,500 g. 57 premature babies of the same birth weight group born in the two preceding years and fed normal pooled breast milk served as a control group. Fresh breast milk was enriched using lyophilized breast milk yielding a calory content of 103 cal/100 ml. Early intermittent nasogastric feeding using this milk enabled full oral calory supply from the 5th day on. 130 ml/kg/day of enriched breast milk yields 134 cal/kg per day with somewhat less fat but more protein (2.8 g/kg vs 2.2 g/kg) and sodium (1.9 mmol vs 1.5 mmol) than 200 ml/kg/day of ordinary breast milk. About 50% of the study patients and the control group needed intensive care with mechanical ventilation. Mortality was 15% and 28%, respectively. Necrotizing enterocolitis was rare in both groups (3.3 vs 3.5%). Due to extragastric complications oral feeding had to be reduced in 18% (study group) and in 27% (ordinary breast milk), the most frequent indication was a patent ductus arteriosus with heart insufficiency. Postnatal weight gain was comparatively good with a mean increment of 112 g in the second and 150 g in the third week. Growth of body length during the first three weeks was on average 0.72 cm/week, head circumference increased 0.57 cm/week. However, in the control group similar results were noted. During the second week of life patients fed concentrated breast milk had somewhat higher plasma sodium und urea values.(ABSTRACT TRUNCATED AT 250 WORDS)