(NewsUSA) - While no one plans to have a baby early, 1 in 10 babies are born prematurely, a rate that has remained persistently high over the past decade. As such, early nutrition decisions in the neonatal intensive care unit (NICU) continue to be critical.

This NICU Awareness Month (September), we’re breaking down the nutritional options available in the NICU and how they can impact both the short and long-term health outcomes for vulnerable preemies.

Let’s Talk Fortifiers

Extremely premature babies need extra nutrition to grow. Preemies need 20-40% more calories and 2-3 times more protein than full-term babies because they missed important growth time in the womb. That's why doctors add a "fortifier" to mom’s breastmilk or donor milk in the NICU. 

Here’s the confusing thing, though. Many parents don't know that there are two completely different types of fortifiers available in the NICU.

One is made from cow milk, and the other is made from 100% donor breastmilk. However, both are labeled “human milk fortifiers,” regardless of whether it is made from cow milk or breastmilk. A company called Prolacta Bioscience offers the only fortifier made from 100% breastmilk, free from cow milk.

Why Nutrition Matters in the NICU

For preemies born weighing 2.75 pounds or less, cow milk can be difficult to digest. Studies show that fortifiers made from cow milk increase the risk of the deadly intestinal disease necrotizing enterocolitis (NEC) in extremely premature infants, when compared to infants fed fortifiers made from 100% breastmilk, as part of an exclusive breastmilk-based diet.

Fortifiers made from 100% breastmilk are designed specifically for premature babies and are being used in NICUs across the country to support better outcomes, fewer complications, and shorter hospital stays. When used as part of an exclusive breastmilk diet, these fortifiers and formulas:

• Reduce the risk of NEC, a life-threatening intestinal disease
• Help preemies go home sooner
• Can mean fewer complications like lung and eye disease  
• Showed improved long-term neurodevelopmental outcomes
• Trusted by NICUs worldwide for feeding over 125,000 patients since 2006
• Used in more than 55% of U.S. NICUs in 2025 for the smallest, most vulnerable preemies

NICU Parents Have Choices for Their Preemie’s Nutrition

When it comes to nutrition options in the NICU, many parents are not informed that they have a choice. This means families might agree to cow milk-based products without knowing another safe nutrition choice exists.

Parents have the right to understand all available options, the evidence behind them, and potential complications before making this important decision for their baby.

In fact, parents can specifically ask their NICU care team about 100% donor breastmilk-based fortifiers and formulas and request these products if they believe it's the best option for their baby. Resources are available to help families navigate these conversations with their care teams.

Parents serve as their baby's strongest advocates. They shouldn't hesitate to ask questions, request information, and push for what they believe is best for their child. The nutritional choices made in those early days and weeks can affect their baby's health in the short and long term.

Parental Advocacy Makes a Difference

This NICU Awareness Month, if you have a preemie in the NICU, or know someone who does, share this important nutritional information. When it comes to feeding fragile preemies, knowledge can save lives. Parents deserve to know that alternatives to cow milk-based fortifiers exist, and that they have a voice in their baby’s care. Every family has the right to make informed decisions, and every preemie deserves the best possible start in life.