Gain velocity and IGA secretory fecal between preterm baby received human milk and human milk fortified

Preterm baby suffered from metabolic stress and hypogammaglobulinemia after birth. Extrauterine growth restriction (EUGR) is a common problem and related to neurodevelopmental outcome. The Independent risk factor of EUGR is necrotizing enterocolitis (NEC). Concentration secretory IgA (sIgA) as main immunity system decreased by age. Human milk fortification may resolve EUGR and organ immaturity of preterm baby. Objective: Analyzed difference gain velocity and sIgA fecal between preterm baby received human milk and human milk fortified. Methods: Prospective analytic observational study between December 2015-July 2016 at Soetomo Hospital Surabaya. Inclusion criteria consisted of gestational age ≤ 34 weeks and birth weight 1000 till less than 2000 g. Multiple congenital anomaly and enteral nutrition avoidance as exclusion criteria. Indication human milk fortification were stable period, no suckling reflex and gain weight velocity (GWV) <10 g/kg/d. Preterm baby was recruited and followed in 14 days. Chi-square, Mann-whitney and t-test independent sample used to analyzed discrepancies GWV, gain length velocity (GLV), gain head circumference velocity (GHC) and sIgA fecal. Results: Human milk fortification (22(12,86-51,76) g/kg/day) showed significance difference to GWV than human milk (14,28(-12,86-(+32,86) g/kg/day) group (p=0,020). GLV(p=0,257), GHC (p=0,215) and sIgA fecal (p=0,418) revealed no difference. Side effects (feeding intolerance and NEC) not found during observation. Conclusions: Human milk fortification showed higher GWV than human milk group. Follow up still needed to evaluate anthropometric parameter.