Osmolality Changes with Increasing Nutritional Content of Feedings for Premature Infants

The American Academy of Pediatrics (AAP) recommends osmolality of infant feedings not to exceed 450 mOsm/Kg. Hyperosmolar feeds may increase intestinal disturbances and necrotizing enterocolitis in premature infants. To meet high nutritional demands, expressed human milk (EHM) is often fortified beyond 24 kcal/oz. The objective was to investigate the osmolality of fortification strategies routinely used in the NICU, and changes in osmolality following 24-hour refrigerated storage.