Enfamil® Liquid Human Milk Fortifier High Protein
Enfamil Liquid Human Milk Fortifier High Protein is added to expressed breast milk for feeding premature and low-birth-weight infants.
Enfamil Liquid Human Milk Fortifier High Protein is added to expressed breast milk for feeding premature and low-birth-weight infants who often need fortified breast milk to meet their increased caloric protein, fat, and other micronutrient needs. Enfamil Liquid Human Milk Fortifier High Protein increases the levels of protein, energy, calcium, phosphorus, iron, vitamin D and other nutrients, producing a diet more suited to the nutritional needs of the rapidly growing premature infant. It has 4 g of protein per 100 Cal when mixed with preterm human milk at the 24 Calorie per fluid ounce concentration.*
*When mixed as directed 5 mL HMF + 25 mL preterm human milk.
- Non-acidified
- Helps to promote growth
- Commercially sterile, convenient 5.5 fl oz bottle designed for easy batch fortification mixing
- 4 g of protein per 100 Cal when mixed with preterm human milk at the 24 Calorie per fluid ounce concentration*
- Protein source is partially hydrolyzed whey protein
- Helps support DHA and ARA status in preterm infants
- Kosher, Halal
*When mixed as directed 5 mL HMF + 25 mL preterm human milk.
Ingredients: Water, whey protein isolate hydrolysate (milk), medium chain triglycerides (MCT oil), soy oil and less than 2%: Mortierella alpina oil†, Schizochytrium Sp oil‡, pectin, vitamin A palmitate, vitamin E acetate, vitamin D3, vitamin K1, thiamin hydrochloride, riboflavin, vitamin B6 hydrochloride, vitamin B12, niacinamide, folic acid, calcium pantothenate, biotin, ascorbic acid, calcium citrate, calcium phosphate, cupric sulfate, sodium citrate, potassium citrate, calcium chloride, ferrous sulfate, magnesium phosphate, magnesium oxide, zinc sulfate.
†A source of arachidonic acid (ARA).
‡A source of docosahexaenoic acid (DHA).
ALLERGEN INFORMATION
Enfamil Liquid Human Milk Fortifier High Protein contains milk and soy.
CAUTION: Nutritionally incomplete. To be used only under the supervision of a physician.
| Per 5 mL Fortifier Only | 20 mL Plus 100 mL Preterm Breast Milk (120 mL mixed to 24 Cal/fl oz concentration)§|| | Per 100 Cal Fortified Preterm Breast Milk when mixed to 24 Cal/fl oz concentration§|| | |
|---|---|---|---|
| Protein, g | 0.56 | 3.9 | 4 |
| Fat, g | 0.58 | 5.8 | 6 |
| Linoleic acid, mg | 58 | 710 | 730 |
| Carbohydrate, g | 0.11 | 7.7 | 7.9 |
| Water, g | 3.8 | 104 | 107 |
| Vitamins/Other Nutrients | |||
| Vitamin A, IU | 290 | 1210 | 1240 |
| Vitamin D, IU | 47 | 200 | 200 |
| Vitamin E, IU | 1.4 | 6 | 6.2 |
| Vitamin K, mcg | 1.42 | 7.7 | 7.9 |
| Thiamin (Vitamin B1), mcg | 46 | 193 | 200 |
| Riboflavin (Vitamin B2), mcg | 66 | 290 | 300 |
| Vitamin B6, mcg | 35 | 146 | 150 |
| Vitamin B12, mcg | 0.16 | 0.66 | 0.68 |
| Niacin, mcg | 920 | 3900 | 4000 |
| Folic acid (Folacin), mcg | 7.7 | 34 | 35 |
| Pantothenic acid, mcg | 230 | 1150 | 1190 |
| Biotin, mcg | 0.84 | 3.9 | 4.1 |
| Vitamin C (Ascorbic acid), mg | 3.8 | 20 | 20 |
| Minerals | |||
| Calcium, mg | 29 | 141 | 145 |
| Phosphorus, mg | 15.8 | 78 | 80 |
| Magnesium, mg | 2 | 11.3 | 11.6 |
| Iron, mg | 0.44 | 1.85 | 1.9 |
| Zinc, mg | 0.24 | 1.33 | 1.37 |
| Manganese, mcg | 2.5 | 10.4 | 10.7 |
| Copper, mcg | 15 | 98 | 101 |
| Sodium, mg | 6.8 | 55 | 57 |
| Potassium, mg | 11.3 | 95 | 98 |
| Chloride, mg | 6.9 | 86 | 88 |
§Calculated using values for preterm human breast milk compiled from multiple published studies; protein value used for preterm human milk is 1.62 g/100 mL.
||Koletzko B, Cheah F-C, Domellof M, Poindexter BB, Vain N, van Goudoever JB (eds): Nutritional Care of Preterm Infants. Scientific Basis and Practical Guidelines. World Rev Nutr Diet. Basel, Karger, 2021 vol 122
| FORTIFIED PRETERM HUMAN MILK NUTRITIONAL PROFILE | ||
|---|---|---|
| ~Cal/fl oz | 22 | 24 |
| Preterm breast milk + ELHMF High Protein | 50 mL + 5 mL | 25 mL + 5 mL |
| Final volume, mL | 55 | 30 |
| Nutrients per 100 Cal | ||
| Energy, Cal | 100 | 100 |
| Protein, g | 3.3 | 4 |
| Fat, g | 5.7 | 6 |
| Carbohydrate, g | 9.2 | 7.9 |
| Water, g | 118 | 107 |
| Vitamins | ||
| Vitamin A activity, IU | 770 | 1240 |
| Vitamin D, IU | 124 | 200 |
| Vitamin E, IU | 3.9 | 6.2 |
| Vitamin K, mcg | 5.9 | 7.9 |
| Thiamin (Vitamin B1), mcg | 123 | 200 |
| Riboflavin (Vitamin B2), mcg | 194 | 300 |
| Vitamin B6, mcg | 93 | 150 |
| Vitamin B12, mcg | 0.41 | 0.68 |
| Niacin, mcg | 2500 | 4000 |
| Folic acid (Folacin), mcg | 23 | 35 |
| Pantothenic acid, mcg | 840 | 1190 |
| Biotin, mcg | 2.7 | 4.1 |
| Vitamin C (Ascorbic acid), mg | 14.6 | 20 |
| Minerals | ||
| Calcium, mg | 101 | 145 |
| Phosphorus, mg | 56 | 80 |
| Magnesium, mg | 8.9 | 11.6 |
| Iron, mg | 1.18 | 1.9 |
| Zinc, mg | 1.04 | 1.37 |
| Manganese, mcg | 6.5 | 10.7 |
| Copper, mcg | 83 | 101 |
| Iodine, mcg | 22 | 18.4 |
| Selenium, mcg | 2.9 | 2.5 |
| Sodium, mg | 51 | 57 |
| Potassium, mg | 89 | 98 |
| Chloride, mg | 88 | 88 |
| Linoleic acid, mg | 730 | 730 |
| Linolenic acid, mg | 54 | 60 |
| ARA, mg | 32 | 38 |
| DHA, mg | 21 | 24 |
| FORTIFIED PRETERM HUMAN MILK NUTRITIONAL PROFILE | ||
|---|---|---|
| ~Cal/mL | 0.74 | 0.81 |
| Preterm human milk + ELHMF High Protein | 50 mL + 5 mL | 25 mL + 5 mL |
| Final volume, mL | 55 | 30 |
| Nutrients per 100 mL | ||
| Energy, Cal | 75 | 81 |
| Protein, g | 2.5 | 3.3 |
| Fat, g | 4.2 | 4.8 |
| Carbohydrate, g | 6.8 | 6.4 |
| Water, g | 88 | 87 |
| Vitamins/Other Nutrients | ||
| Vitamin A activity, IU | 570 | 1010 |
| Vitamin D, IU | 93 | 167 |
| Vitamin E, IU | 2.9 | 5 |
| Vitamin K, mcg | 4.4 | 6.4 |
| Thiamin (Vitamin B1), mcg | 92 | 161 |
| Riboflavin (Vitamin B2), mcg | 145 | 240 |
| Vitamin B6, mcg | 69 | 122 |
| Vitamin B12, mcg | 0.31 | 0.55 |
| Niacin, mcg | 1860 | 3300 |
| Folic acid (Folacin), mcg | 16.8 | 28 |
| Pantothenic acid, mcg | 630 | 960 |
| Biotin, mcg | 2 | 3.3 |
| Vitamin C (Ascorbic acid), mg | 10.9 | 16.7 |
| Minerals | ||
| Calcium, mg | 75 | 118 |
| Phosphorus, mg | 42 | 65 |
| Magnesium, mg | 6.6 | 9.4 |
| Iron, mg | 0.88 | 1.54 |
| Zinc, mg | 0.77 | 1.11 |
| Manganese, mcg | 4.9 | 8.7 |
| Copper, mcg | 62 | 82 |
| Iodine, mcg | 16.2 | 14.8 |
| Selenium, mcg | 2.2 | 2 |
| Sodium, mg | 38 | 46 |
| Potassium, mg | 66 | 79 |
| Chloride, mg | 65 | 72 |
| Additional Nutrients | ||
| Linoleic acid, mg | 540 | 590 |
| Linolenic acid, mg | 40 | 48 |
| ARA, mg | 24 | 31 |
| DHA, mg | 15.6 | 19.2 |
| FORTIFIED TERM HUMAN MILK NUTRITIONAL PROFILE | ||
|---|---|---|
| ~Cal/fl oz | 22 | 24 |
| Term human milk + ELHMF High Protein | 50 mL + 5 mL | 25 mL + 5 mL |
| Final volume, mL | 55 | 30 |
| Nutrients per 100 Cal | ||
| Energy,1 Cal | 100 | 100 |
| Protein,1 g | 2.4 | 3.3 |
| Fat,1 g | 5.6 | 6 |
| Carbohydrate,1 g | 10 | 8.7 |
| Water, g | 118 | 108 |
| Vitamins/Other Nutrients | ||
| Vitamin A activity,1 IU | 880 | 1340 |
| Vitamin D,1 IU | 116 | 194 |
| Vitamin E,1 IU | 4.4 | 6.6 |
| Vitamin K,1 mcg | 3.7 | 6.2 |
| Thiamin (Vitamin B1),1 mcg | 122 | 200 |
| Riboflavin (Vitamin B2),1 mcg | 220 | 320 |
| Vitamin B6,1 mcg | 109 | 164 |
| Vitamin B12,1 mcg | 0.48 | 0.74 |
| Niacin,1 mcg | 2700 | 4200 |
| Folic acid (Folacin),1 mcg | 32 | 43 |
| Pantothenic acid,1 mcg | 830 | 1180 |
| Biotin,1 mcg | 2.9 | 4.2 |
| Vitamin C (Ascorbic acid),1 mg | 21 | 26 |
| Choline,2 mg | 19.4 | 16.4 |
| Inositol,3 mg | 32 | 27 |
| Minerals | ||
| Calcium,1 mg | 98 | 143 |
| Phosphorus,1 mg | 54 | 78 |
| Magnesium,1 mg | 8.8 | 11.6 |
| Iron,1 mg | 1.14 | 1.87 |
| Zinc,1 mg | 0.82 | 1.19 |
| Manganese,1 mcg | 6.4 | 10.6 |
| Copper,1 mcg | 73 | 92 |
| Iodine,1 mcg | 18.2 | 15.4 |
| Selenium,1 mcg | 2.4 | 2.1 |
| Sodium,1 mg | 39 | 47 |
| Potassium,1 mg | 85 | 95 |
| Chloride,1 mg | 68 | 73 |
| Additional Nutrients | ||
| Linoleic acid,4 mg | 830 | 820 |
| Linolenic acid,4 mg | 62 | 67 |
| ARA,5 mg | 32 | 38 |
| DHA,5 mg | 21 | 24 |
| FORTIFIED TERM HUMAN MILK NUTRITIONAL PROFILE | ||
|---|---|---|
| ~Cal/mL | 0.74 | 0.81 |
| Term human milk + ELHMF High Protein | 50 mL + 5 mL | 25 mL + 5 mL |
| Final volume, mL | 55 | 30 |
| Nutrients per 100 mL | ||
| Energy,1 Cal | 75 | 81 |
| Protein,1 g | 1.84 | 2.7 |
| Fat,1 g | 4.2 | 4.8 |
| Carbohydrate,1 g | 7.5 | 7 |
| Water, g | 89 | 88 |
| Vitamins/Other Nutrients | ||
| Vitamin A activity,1 IU | 660 | 1090 |
| Vitamin D,1 IU | 87 | 158 |
| Vitamin E,1 IU | 3.3 | 5.3 |
| Vitamin K,1 mcg | 2.8 | 5 |
| Thiamin (Vitamin B1),1 mcg | 92 | 161 |
| Riboflavin (Vitamin B2),1 mcg | 165 | 260 |
| Vitamin B6,1 mcg | 82 | 133 |
| Vitamin B12,1 mcg | 0.36 | 0.6 |
| Niacin,1 mcg | 2000 | 3400 |
| Folic acid (Folacin),1 mcg | 24 | 35 |
| Pantothenic acid,1 mcg | 620 | 960 |
| Biotin,1 mcg | 2.2 | 3.4 |
| Vitamin C (Ascorbic acid),1 mg | 16 | 21 |
| Choline,2 mg | 14.5 | 13.3 |
| Inositol,3 mg | 24 | 22 |
| Minerals | ||
| Calcium,1 mg | 73 | 116 |
| Phosphorus,1 mg | 41 | 63 |
| Magnesium,1 mg | 6.6 | 9.4 |
| Iron,1 mg | 0.85 | 1.52 |
| Zinc,1 mg | 0.62 | 0.97 |
| Manganese,1 mcg | 4.8 | 8.6 |
| Copper,1 mcg | 55 | 75 |
| Iodine,1 mcg | 13.6 | 12.5 |
| Selenium,1 mcg | 1.82 | 1.67 |
| Sodium,1 mg | 29 | 38 |
| Potassium,1 mg | 64 | 78 |
| Chloride,1 mg | 51 | 59 |
| Additional Nutrients | ||
| Linoleic acid,4 mg | 620 | 670 |
| Linolenic acid,4 mg | 46 | 54 |
| ARA,5 mg | 24 | 31 |
| DHA,5 mg | 15.6 | 19.2 |
1.Picciano MF. Nutrient composition of human milk. Pediatr Clin North Am. 2001 Feb;48(1):53-67, 263-264
2.Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US); 1998
3.Pereira GR, Baker L, Egler J, Corcoran L, Chiavacci R. Serum myoinositol concentrations in premature infants fed human milk, formula for infants, and parenteral nutrition. Am J Clin Nutr. 1990;51(4):589-93
4.Innis SM. Human milk and formula fatty acids. J Pediatr. 1992; 120(4 Pt 2):S56-61
5.Brenna JT, Varamini B, Jensen RG, Diersen-Schade DA, Boettcher JA, Arterburn LM. Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. Am J Clin Nutr. 2007;85(6):1457-64.
| Nutrient Density | Fortified Preterm Human Milk to 24 Cal (1:5 ratio HMF to preterm milk) | Fortified Preterm Human Milk to 22 Cal (1:10 ratio HMF to preterm milk) |
|---|---|---|
| Potential Renal Solute Load (mOsm/100 Calories)6 | 33 | 28 |
| Osmolality (mOsm/kg H2O) | 290-350 | 280-340 |
6. Fomon SJ, Ziegler EE. Renal solute load and potential renal solute load in infancy. J Pediatr 1999;134(1):11–14.
Use as directed by the baby’s doctor. Shake gently before using. Do not shake vigorously to minimize product foaming. Foaming is normal with this product. Remove protective seal around cap, remove cap and foil seal. This product is commercially sterile as produced. Only use in a formulary or centralized milk preparation room where there is little risk of contamination, using proper aseptic technique.7
A variety of aseptic preparation methods are available including the use of sterile containers, or sterile transfer lids and sterile, single-use, enteral syringes. When using sterile containers, after opening bottle pour into disposable, sterile container and draw up needed volume into a sterile, single-use, enteral syringe. Dispense into measured breast milk and swirl. For directions using sterile transfer lids and sterile, single-use, enteral syringes, see carton.
Failure to follow these instructions could result in severe harm. Opened bottles and fortified breast milk can spoil quickly. Either use immediately or replace fortifier bottle cap and store in refrigerator at 35-40°F (2-4°C) for no longer than 48 hours. Gently agitate product before each use. After feeding begins, use fortified breast milk within one hour or discard. After 48 hours of opening, discard any unused product. Do not freeze.
Add fortifier to breast milk according to the following chart for mixing:
| Additional Calories Desired (per fl oz concentration) | Breast Milk | Enfamil Liquid Human Milk Fortifier High Protein | ||Total Concentration |
|---|---|---|---|
| (Breast Milk + LHMF)|| | |||
| 2 Calories/fl oz | 50 mL | 5 mL | 22 Cal/fl oz concentration |
| 4 Calories/fl oz | 25 mL | 5 mL | 24 Cal/fl oz concentration |
The baby's doctor will provide instructions for the desired amount of calories to add.
WARNING: Do not use product that has unusual characteristics.
WARNING: Do not use a microwave oven to warm the fortified breast milk. Serious burns may result.
WARNING: Not for parenteral (I.V.) use. Do not administer directly—must add to breast milk
7. Infant and Pediatric Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities. 3rd ed.; 2018.
Mixing New Enfamil Liquid Human Milk Fortifier
High Protein & Standard Protein
With Jodee Le Vin
RDN, CNSC, CLC, LD
Enfamil® Human Milk Fortifier Liquid High Protein is available in an ultra-concentrated liquid to increase nutrients while minimizing the need for other modular supplements and is designed for convenient batch fortification mixing, using proper aseptic technique1.
When using this information, please note the following:
Coding systems and reimbursement allowable rates vary by payer:
- Medicare Part B uses HCPCS (Healthcare Common Procedure Coding System) to group products
- Medicaid systems vary by state; some use HCPCS while others use NDC format code or systems of their own—contact your state provider for more information
- Private health insurance and managed care companies may use HCPCS, NDC format code or their own system—contact your provider for more information
Enfamil® Human Milk Fortifier Liquid High Protein
Item #: 178301
Description: Liquid
Unit Size: 5.5 fl oz
Calories/Unit: 244
Product Yield/Unit (fl oz): 5.5 fl oz
Case: 24 bottles per case
HCPCS Code: B4155*
NDC Format Code: 00087-5125-32