For a study, researchers sought to compare growth (weight, length, head circumference, and knee–heel length [KHL]) in VLBW babies (500–1500 g) who received human milk fortified with a liquid fortifier (LHMF) with high protein and fatty acid content with a typical powder fortifier (PHMF) for 45 days or until discharge. A multicenter, randomized, controlled trial was used in the study. To assess adverse events and withdrawal reasons, an intention-to-treat analysis was undertaken. They also conducted an effectiveness analysis on the infants who had completed at least two weeks of research.

About 146 of the 158 babies included in the trial completed at least 2 weeks of the study, and 125 finished the whole study. Weight increases (22.9 vs 22.7 g kg1 day1), length (1.03 vs 1.09 cm/week), head circumference (0.91 vs 0.90 cm/week), and KHL (3.6 vs 3.3 mm/week) were also comparable between groups. Infants weighing more than 1 kg who received LHMF saw a larger increase in KHL (3.7 vs 3.2 mm/week, P=0.027). Although there were no significant differences in major adverse events, the difference in the incidence of the composite outcome death/necrotizing enterocolitis across groups was noteworthy (1.3% with LHMF and 8.1% with PHMF). The overall development of VLBW babies using either fortifier was not different.