Comparison of growth outcomes between human milk fed preterm infants on standard versus adjustable fortification

INTERVENTION: adjustable fortification,standard fortification Experimental Dietary Supplement,Experimental Dietary Supplement In the adjustable fortification group, protein of 0.5 g/100 ml was initially added to the standard fortified HM to achieve a target of 3.5‐4 g/kg/day protein. Further protein adjustments were made them based on each preterm infant's protein metabolism, which was determined by blood urea nitrogen (BUN) weekly,Standard fortification was performed by adding a fixed amount of fortifier to mother's own milk or donor human milk 25 ml+ HMF 1 sachet (24 kcal/oz) as per the manufacture's recommendation HMF [Mead Johnson nutritional]. CONDITION: healthy infants gestational age less than 32 weeks and weighing less than 1800 grams ; Preterm, Human milk, Human milk fortifier, Protein, Growth Preterm, Human milk, Human milk fortifier, Protein, Growth PRIMARY OUTCOME: growth outcomes the study duration was 28 days or discharge which ever comes first. birth weight, length, head circumference SECONDARY OUTCOME: chemical parameters weekly serum blood urea nitrogen (BUN), creatinine, and albumin,clinical outcomes the study duration was 28 days or discharge which ever comes first. confirmed necrotizing enterocolitis , feeding intolerance, late‐onset neonatal culture‐proven sepsis and other, nosocomial infections, length of stay, extrauterine growth restriction INCLUSION CRITERIA: All Preterm infants with GA < 32 weeks and weight < 1800 grams, admitted in the neonatal unit of QSNICH