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Human milk–based fortifiers matter to critically ill and premature infants

Premature infants need additional calories and protein that are vital to their survival, growth, and development.

While breastmilk is perfect nutrition for full-term babies, it does not provide enough nutrition for preemies. This is why the American Academy of Pediatrics (AAP) recommends adding a “human milk fortifier” to mother’s own milk or pasteurized donor breastmilk for babies born weighing 3.3 pounds (1500 grams) or less.1

These fortifiers provide the added calories and protein preemies need.

Human milk = vital nutrition to thrive

Your breastmilk plays a vital role in your baby’s health. When your care team adds Prolacta’s fortifiers, the goal is to achieve improved health outcomes as shown in clinical studies.2,3,4,5,6,7 These can include decreases in:

  • Bronchopulmonary dysplasia (BPD)5,6,8
  • Late-onset sepsis5,7,8
  • Retinopathy of prematurity (ROP)5,6,8
  • Necrotizing enterocolitis (NEC)2,5
  • Feeding intolerance decreases6

Studies have also shown that premature infants can go home sooner from the NICU with the use of Prolacta’s fortifiers.5,6

Understand the difference

Learn more about human milk–based fortifiers and why Prolacta’s products are clinically important

Read the studies

More than 20 clinical studies have shown the proven clinical benefits of Prolacta’s fortifiers

Advocate for your baby

Ensure your baby has access to clinically proven human milk–based nutrition in the NICU

Not all “human milk fortifiers” are made from human milk

There are two types of fortifiers available in the neonatal intensive care unit (NICU). While both are labeled “human milk fortifier,” one type is made from cow milk.

Studies have shown cow milk-based fortifiers can trigger feeding intolerance and increase mortality due to the risk of severe complications. These complications can include late-onset sepsis, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC). 2, 3, 4, 6

The other type of human milk fortifiers are made from 100% human milk by Prolacta. The breastmilk used to create our fortifiers is donated by healthy donors. As a part of our extensive screening process, we do a DNA match to ensure all the milk received comes directly from our carefully screened and vetted donors.

It’s important to know your human milk fortifier options. Be sure to talk with your care team about Prolacta’s 100% human milk–based fortifiers.

Helping 63,000+ infants globally, and counting

In clinical studies, preemies weighing 2 pounds 12 ounces (1250 grams) or less at birth fed Prolacta’s fortifiers as part of a 100% human milk diet experienced fewer complications, went home from the hospital sooner, and showed improved growth rates.9,10 More than 63,000 premature infants globally have benefited from the clinically proven advantages of Prolacta’s human milk–based human milk fortifiers.

Parent experiences

In addition to the studies, hear from NICU parents who have been where you are now.

The Story of Baby Kallie, as Told by Her Mom, Ebonie


My pregnancy with Kallie was identified as high risk early due to my high blood pressure. My obstetrician proactively managed it and placed me on medication. I didn't gain weight during the pregnancy, as a matter of fact, I lost weight. However, the doctor did not seem too concerned since I was a little overweight to begin with. On May 20, at just 24 weeks and 3 days into my pregnancy, the ultrasound technician noticed several things that were a cause for major concern:

  • I lost most of my amniotic fluid
  • Kallie was the size of a 21-week-gestation baby even though I was over 24 weeks along
  • Blood flow between the placenta to the umbilical cord to Kallie was absent end-diastolic flow

That same day, I was sent to a hospital 40 minutes away and put on bed rest so doctors could closely monitor the blood flow from my placenta and to ensure Kallie stayed inside as a long as possible. At 25 weeks, during a routine umbilical cord ultrasound, the doctors saw that the blood flow to my placenta had started to reverse. It was time for Kallie to be delivered. She was born at 25 weeks gestation via emergency c-section on May 24. She weighed 370 g (13.1 oz) and was whisked away to the hospital's level III neonatal intensive care unit (NICU).

Almost 6 hours after delivery, after most of the medications had worn off, I was wheeled over in my hospital bed to see Kallie for the first time. I had so many feelings and emotions going through my mind at first sight of her. She was smaller than any other baby I had ever seen. I was scared, but I knew she was here for a reason and was ready to fight.

The days in the NICU were long, anxiety was high, and each milestone felt like they took forever to reach. But overall, I would say our NICU experience was good. Kallie needed several blood transfusions, she had one or two bouts of low white blood cell count, and she underwent patent ductus arteriosus (PDA) ligation surgery at 4 weeks old. Our biggest hurdle was oxygen. Kallie was intubated for 8 weeks, and after extubating, she required various forms of ventilation support during her 150-day NICU journey.

Providing Breastmilk in the NICU

I started pumping the day Kallie was born and kept pumping every 3 hours. I had ample supply and packed the NICU freezer. Her very first taste of my breastmilk was on a swab through what I learned was called "oral care." Feeding has proven to be our biggest challenge during and after NICU life.

Fortifying my breastmilk

I heard about Prolact+ H2MF from Kallie's neonatologist. She mentioned that Prolacta’s fortifier is made from 100% human milk and it would be added to my breastmilk so that Kallie would get the additional calories she needed to grow and gain weight. Kallie’s first time having Prolacta fortifiers was around 31 weeks gestation for a little less than a month. At the start, she weighed 880 g and one month later she weighed 1435 g, a weight increase of 555 g. The month before getting Prolacta fortifiers, Kallie's weight went from 620 g to 880 g, a weight increase of only 260 g. Looking back, Prolacta fortifiers gave her a great boost and helped her gain more than double the weight she gained the month before. Kallie was extubated 9 days after starting on Prolacta fortifiers.

NICU Grad Kallie

NICU graduation

Kallie graduated from the NICU at 150 days, just shy of 5 months. She weighed 7 lb 4 oz. She came home with a nasogastric (NG) tube and nasal canula for oxygen support, but all her other milestones were met. Kallie was recognized as one of the smallest babies to ever be cared for at her NICU and made national news.

Kallie today

Today, Kallie is 11 months old (about 8 months corrected age) and currently weighs about 14 lb 5 oz. She loves trying to stand on her own, sitting up to observe the room, and she absolutely loves her big brothers. She lights up whenever they enter the room. She is still dependent on the NG tube. She loves when we clap, sing, and dance for her, and her favorite songs are “ABCs,” “If You’re Happy and You Know It,” and “5 Little Ducks.”

Advice for parents in the NICU

No matter how long your stay is in the NICU, it’s a hard place to be, but there are so many resources to help you get through it. Join a Facebook group for NICU parents and attend NICU events put on by your hospital. Surrounding yourself with people who are currently in the NICU or who have graduated is the best soup for your soul. They are the ones who will understand your heartaches, pains, and joys. NICU parents celebrate EVERYTHING from moving up in diaper sizes to gaining an OUNCE. Always ask questions and advocate for your baby! And since no two journeys are the same, never ever compare. I hold a special place in my heart for NICU parents. Please feel free to reach out.   Ebonie Bender


The Story of Evelyne, as told by her Mom, Tiffany

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Evelyne is our first baby. Prior to her birth, I had several miscarriages. My pregnancy with Evelyne was not easy—I experienced many complications starting with a hematoma in my early months, followed by an incompetent cervix at 19 weeks which required transportation to another hospital and a rescue cerclage (surgical stitch of the cervix to prevent premature labor). After weeks of bedrest, my water broke at 24 weeks and I was admitted to the hospital on bedrest. Four weeks later, Evelyne was delivered via emergency c-section at 28 weeks gestation weighing 1130 g (2 lb 8 oz).

The NICU Experience

My husband and I are vegan and are adamant about living a chemical-free lifestyle. Given this, we really felt it was important to minimize our daughter’s exposure to unnecessary chemicals during her NICU stay. We asked the NICU staff to use chemical-free soaps, lotions, and creams that we brought in and the staff obliged our requests.

Evelyne was on respiratory support until she was 35 weeks and had jaundice but was otherwise healthy under the circumstances. She also had frequent apneas, which were closely monitored and required manual intervention. 

Feeding in the NICU

The same day Evelyne was born I met with a lactation consultant who told me about Prolacta’s 100% human milk–based fortifiers. Prolacta’s fortifiers were available at Evelyne’s NICU, but only for the sickest preemies. 

Since Evelyne did not qualify she would be receiving a fortifier made from cow’s milk. As a vegan, we were opposed to this. I insisted that if the NICU felt that a fortifier was necessary for my baby I would refuse anything other than a human milk–based fortifier. Our request moved up the hospital chain of command and eventually we were granted permission to feed Evelyne Prolact+ H2MF® human milk fortifier, the only fortifier made from 100% breastmilk. It was a long process but completely worth it. 

After the NICU

Evelyne was discharged after 81 days in the NICU and weighed about 4 and a half pounds. She is currently 1 year old and thriving, but still quite small weighing only 15 pounds. Her doctor said that she excels in her fine motor skills and was impressed that she could walk with assistance at 10 months of age (6 months corrected). She is a bright and alert baby, with no developmental shortcomings for her actual age. She is truly the happiest baby. My husband and I always tell people she has two moods: happy and sleepy! I credit her current health and vitality to breastmilk, kangaroo care, and Prolacta!

Advice for NICU Parents

Be an advocate for your baby and follow your instincts! We were polite but firm with the staff. We listened to their recommendations and did our own research. I know that I did everything in my power and control to ensure that my baby had the healthiest start in life.  Speak your mind and advocate for YOUR baby!

The Story of Kai and Maryn, As Told by Their Mom, Katie

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I was 19 weeks pregnant with twins when I experienced preterm premature rupture of membranes (PPROM) with my daughter Maryn Frances. Knowing that there was a high chance of early delivery, I chose to be on bedrest. I managed to carry the twins for another 7 weeks before my emergency c-section. As I waited for my husband to make the 5-hour drive to the hospital, I remember wondering if our twins would live long enough to meet either of us. I was terrified the entire time.  

Our twins were born at 26 weeks and 2 days. Kai Joseph was born first at 2:12 am. He weighed 2 lb 3 oz and was 14.5 inches long. One minute later, Maryn Frances was born at 2:13 am. She weighed 1 lb 12 oz and was 13 inches long. I’ve been told they each made a little cry! 

For seven weeks we prayed, hoped, and wondered if Maryn would be able to grow lung tissue after PPROM. I’ll never forget their neonatologist (one of my greatest heroes) coming to my recovery room and saying, “she has lungs.” These were the sweetest words I’d ever heard! 


The NICU Rollercoaster

The NICU is always full of ups and downs and our experience was no different from that of many other NICU parents. Maryn had 3 failed extubations and Kai needed surgery to repair 2 hernias. Despite the distance, I am grateful for choosing this particular hospital  -  they absolutely saved my twins’ lives.

I pumped my breastmilk around the clock, and my milk was fortified with Prolact+ H2MF, the only fortifier made from 100% breastmilk, until they reached 34 weeks gestation. My husband and I believe that it made a world of difference for our twins to start their lives with 100% human milk diet! 

Kai was discharged after 103 days and Maryn after 114 days! Maryn came home on oxygen and had to use a nasogastric tube. She was fully off oxygen at 11 months old. 

What are PROM and PPROM?

Premature rupture of membranes (PROM) which is when the amniotic sac that holds your baby breaks and leaks before labor begins. Preterm premature rupture of membranes (PPROM) is a when the amniotic sac breaks and leaks before 37 weeks of pregnancy. Premature birth is a major risk factor for both PPROM and PROM. Learn more about the symptoms of leaking amniotic fluid by click here.


Leaking Amniotic Fluid (Premature Rupture of Membranes) During Pregnancy. What to Expect website. Accessed January 8, 2020.

The twins are now 21 months old and are the healthiest preemies you’ve ever seen! They have both hit every developmental milestone for their corrected age. They have never been readmitted and have been able to fight off colds like champs. I continued to pump for them for well over a year and they received my breastmilk until they were 19 months old. During this time, I was even able to donate over 4,000 oz of my milk to others. I’m so grateful that we started them on a 100% human milk diet and I truly believe it equipped me to continue giving them my breastmilk for as long as I did.

My Advice to NICU Moms

For new moms, I would first say that I hope you have a long and boring pregnancy. But if that didn’t happen and you find yourself in the NICU, pump pump pump! Get on a good pumping schedule and stick to it. Kangaroo your sweet babes as often as possible. Reach out to Mamas who have been there before. Take it one day at a time, but try to keep in mind that it’s only a season and it will pass. 

What to expect in the NICU

You didn’t plan on meeting your baby weeks or even months before your due date. Learn what to expect in the NICU with your premature baby.