Balancing the Nutritional Needs of Very Low Birth Weight Infants with the Protective Properties of Human Milk

Human milk feeding in very low birth weight (VLBW) infants is associated with lower risk of the serious and life threatening complications of prematurity.  Multiple biological mechanisms function to protect infants against bacterial and viral infections and subsequent inflammation.  However, VLBW infants have high nutrient requirements which human milk alone can not meet.  Calcium, phosphorus, and protein requirements are especially high and are challenging to meet with human milk.  The dietitian’s role in promoting human milk feeding as well as possible approaches to meeting nutrient needs and achieving optimal growth in VLBW infants are discussed.