Severe feeding intolerance in extremely preterm neonates successfully treated with human milk derived human milk fortifier: A case series

Feeding intolerance in preterm infants can be severe and can lead to clinical suspicion and diagnostic testing for other acute abdominal surgical pathologies and hence delay achievement of full enteral feeds. We present two cases of extremely premature infants who presented with recurrent severe feeding intolerance following fortification of human milk with a bovine human milk fortifier (HMF). Subsequently, both infants had an extensive workup for their symptoms. Each infant was eventually tried on a human HMF which led to the complete resolution of symptoms in each case. This case series highlights that clinicians should consider the use of human HMF for preterm infants with severe feeding intolerance secondary to the use of bovine HMF.