Carbohydrate supplementation of human milk to promote growth in preterm infants

No evidence to show the effect of adding carbohydrate to breast milk to promote growth in babies born preterm. Breast milk is the best source of nutrition for full-term babies for at least the first six months of life. Babies born preterm (before 37 weeks) have different nutritional needs and it is possible that premature breast milk may not meet all these needs. Adding carbohydrate to breast milk may help. It may help gain weight, without the problems that can come from protein supplements (see Cochrane review on protein supplements). However carbohydrate supplements may cause diarrhea and feeding problems. There have been no published trials evaluating the effect of adding carbohydrate to breast milk to promote growth in preterm babies. More research is needed.

Authors' conclusions: 

There are no studies which have specifically evaluated the addition of carbohydrate alone for the purpose of improving growth and neurodevelopmental outcomes. No recommendations for practice can be made. Research should be directed towards comparison of different quantities and types of carbohydrate in multicomponent fortifiers containing protein and minerals, specifically evaluating short-term growth and long-term growth and neurodevelopmental outcomes.

Read the full abstract...

This section is under preparation and will be included in the next issue.


The main objective was to determine if addition of carbohydrate supplements to human milk leads to improved growth and neurodevelopmental outcomes without significant adverse effects in preterm infants.

Search strategy: 

The standard search strategy of the Neonatal Review Group was used. This includes searches of the Oxford Database of Perinatal Trials, MEDLINE (1966-Apr 2002), Cochrane Controlled Trials Register (The Cochrane Library, Issue 2, 2002), previous reviews including cross references, abstracts, conferences and symposia proceedings, expert informants, journal handsearching mainly in the English language.

Selection criteria: 

All trials utilising random or quasi-random allocation evaluating the supplementation of human milk with carbohydrate in preterm infants within a nursery setting were eligible.

Data collection and analysis: 

Not applicable.

Main results: 

No eligible trials were found.