Enfamil® Liquid Human Milk Fortifier High Protein, 5 mL Sachet
Enfamil Liquid Human Milk Fortifier High Protein is added to expressed breast milk for feeding premature and low-birth-weight infants. It provides enriched nutrition needed by these special babies while still allowing them to receive their mother’s milk. 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 5mL HMF + 25mL preterm human milk
Enfamil® Liquid Human Milk Fortifier is designed for premature infants as a nutritional supplement to be added to breast milk.
- The only Liquid Human Milk Fortifier available in TWO protein amounts and TWO sizes for flexible fortification feeding options.
- TWO sizes: multi-use bottles and NEW single-serve sachets
- TWO targeted protein amounts (Standard Protein and High Protein)
- Non-acidified
- 5 mL sachets designed for greater flexibility with individual feeding needs
- Well tolerated with favorable lean growth outcomes1
- Designed to provide a lower osmolality, similar to that of breast milk*
- Same trusted formulation as the 5.5 fl oz Flex-Pro Bottles
- Kosher Dairy (OU-D), Halal
- Post discharge use is based on physician's recommendation and instructions for preparation and use.
1.Moya F, Fowler J, Florens A, et al. Human milk fortification: impact of a new fortifier on growth velocity and tolerance; a retrospective study. Supporting Information. Abstract presented at: PAS Meeting; April 29, 2023; Washington, DC.
*Breast milk average osmolality is ~290-320 mOsm/kg, calculated using values for preterm human breast milk compiled from multiple studies.
Ingredients: Water, whey protein isolate hydrolysate (milk), medium chain triglycerides (MCT oil), soy oil and less than 2%: Mortierella alpina oil,|| Schizochytrium Sp. oil,¶ magnesium oxide, 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, 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.
| Per 5 mL Fortifier Only | 20 mL Plus 100 mL Preterm Human Milk (120 mL mixed to 24 Cal/fl oz concentration) †‡ | Per 100 Cal Fortified Preterm Human 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 1.62g/100mL
‡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 HUMAN MILK INFORMATION
| Fortified Preterm Human Milk Prepared to 22 or 24 Cal/fl oz | Per 100 Cal at 22 Cal/fl oz | Per 100 Cal at 24 Cal/fl oz|| |
|---|---|---|
| Recipe | ||
| Preterm human milk + Enfamil Liquid HMF High Protein | 50 mL + 5 mL | 25 mL + 5 mL |
| Final volume, mL | 55 | 30 |
| Nutrients | ||
| 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 Prepared to 22 or 24 Cal/fl oz | Per 100 mL at 22 Cal/fl oz | Per 100 mL at 24 Cal/fl oz|| |
|---|---|---|
| Recipe | ||
| Preterm human milk + Enfamil Liquid HMF High Protein | 50 mL + 5 mL | 25 mL + 5 mL |
| Final volume, mL | 55 | 30 |
| Nutrients | ||
| 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 Milk1-5 Prepared to 22 or 24 Cal/fl oz | Per 100 Cal at 22 Cal/fl oz | Per 100 Cal at 24 Cal/fl oz |
|---|---|---|
| Recipe | ||
| Term human milk + Enfamil Liquid HMF High Protein | 50 mL + 5 mL | 25 mL + 5 mL |
| Final volume, mL | 55 | 30 |
| Nutrients | ||
| 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 Milk1-5 Prepared to 22 or 24 Cal/fl oz | Per 100 mL at 22 Cal/fl oz | Per 100 mL at 24 Cal/fl oz |
|---|---|---|
| Recipe | ||
| Term human milk + Enfamil Liquid HMF High Protein | 50 mL + 5 mL | 25 mL + 5 mL |
| Final volume, mL | 55 | 30 |
| Nutrients | ||
| 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.
The baby’s health depends on carefully following the instructions below. Use only as directed by a medical professional. Improper hygiene, preparation, concentration, use or storage may result in severe harm.
Follow hospital rules or the baby’s doctor’s instructions for the safe handling and fortification of breast milk. Opened sachets can spoil quickly. Use fortifier immediately and discard any remaining, unused fortifier.
This product is commercially sterile as produced.
Directions for Use:
- Pour desired quantity of breast milk into a sterile feeding container.
- Gently massage HMF sachet until uniform as some product separation is normal.
- Use perforation to completely tear open sachet.
- Add desired amount of HMF to breast milk in sterile feeding container.
- Shake until mixed well. Fortified breast milk can spoil quickly. Either feed fortified breast milk immediately or cover and store in refrigerator at 35-40 degrees Fahrenheit (2-4 degrees C) for no longer than 24 hours. After feeding begins, use fortified breast milk within one hour or discard.
Directions for When Stored:
Refrigerate unused fortified breast milk and use within 24 hours. After refrigeration, gently remix and feed immediately. Discard remaining fortified breast milk promptly after bottle feeding session.
Storage:
Store unopened sachets in carton at room temperature. Avoid excessive heat and prolonged exposure to light. Do not freeze.
Warning: Do not use a microwave oven to warm the fortified breast milk. Serious burns may result.
Warning: Do not administer directly– must add to breast milk.
Warning: Not for parenteral (I.V.) use
Do not use if sachet is damaged. Use by date on carton or sachet.
Mixing New Enfamil Liquid Human Milk Fortifier
Enfamil® Liquid Human Milk Fortifier 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, single-serve administration. 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, 5mL Sachet
Item #: 178302
Description: Liquid
Unit Size: 5 mL sachet
Calories/Unit: 7.5
Product Yield/Unit (fl oz): 5 mL
Case: 144 sachets per case
HCPCS Code: B4155*
NDC Format Code: 00087-5129-90
*HCPCS application in progress