Parent and Provider Perspectives on the Imprecise Label of “Human Milk Fortifier” in the NICU

In the critical care of preterm infants, feeding is complex and potentially harmful to an immature gastrointestinal system. Parents have expressed the desire to be fully informed about what is being fed to their child, as this places them in the best position to nurture their child’s health. In the parent-engaged setting of the Necrotizing Enterocolitis Symposium, NICU parents expressed concern and confusion about how cow’s milk product and donor human milk product both carry the label “Human Milk Fortifier” (HMF). Accordingly, two online surveys were developed to characterize how the label HMF is used and interpreted in the NICU by parents and providers. Of 774 United States participants, only 21.9% of providers reported consistently describing the source of HMF to parents, and only 20.6% of parents whose child received an HMF product report knowing the source. Parents expressed that they were “not given information” regarding HMF, while both parents and healthcare providers expressed that “the label (HMF) is misleading”. This study documents the ambiguity around the label HMF as well as the need for more specific language and clearer communication.