Products

    Enfamil® Human Milk Fortifier Acidified Liquid

    Add to expressed breast milk to support growth and improve DHA and ARA status in premature or low birth weight infants

    Indication

    Enfamil Human Milk Fortifier Acidified Liquid is to be added to expressed breast milk for feeding premature or low birth weight infants. It provides enriched nutrition needed by these special babies while still allowing them to receive their mother’s milk. Enfamil Human Milk Fortifier Acidified Liquid 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.

    Ingredients

    Ingredients: Water, whey protein isolate hydrolysate (milk), medium chain triglycerides (MCT oil), vegetable oil (soy and high oleic sunflower oils) and less than 2%: Mortierella alpine oil*, Crypthecodinium cohnii 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, citric acid, ferrous sulfate, magnesium phosphate, zinc sulfate.

    *A source of arachidonic acid (ARA).

    †A source of docosahexaenoic acid (DHA).

    POTENTIAL ALLERGENS

    Enfamil Human Milk Fortifier Acidified Liquid contains milk and soy.

    Nutrients

    (Normal Dilution)

    Per 4 Vials

    4 Vials Plus 100 mL

    Per 100 Cal

     

    (30 Cal)

    Preterm Breast Milk* (97 Cal)

    Fortified Preterm Breast Milk*

    Protein, g

    2.2

    3.8

    4

    Fat, g

    2.3

    5.8

    6

    Linoleic acid, mg

    230

    710

    730

    Carbohydrate, g

    <1.2

    7.9

    8.1

    Water, g

    15.1

    104

    107

    Vitamins/Other Nutrients

         

    Vitamin A, IU

    1160

    1210

    1250

    Vitamin D, IU

    188

    200

    210

    Vitamin E, IU

    5.6

    6

    6.2

    Vitamin K, mcg

    5.7

    7.7

    7.9

    Thiamin (Vitamin B1), mcg

    184

    193

    200

    Riboflavin (Vitamin B2), mcg

    260

    290

    300

    Vitamin B6, mcg

    140

    146

    151

    Vitamin B12, mcg

    0.64

    0.66

    0.68

    Niacin, mcg

    3700

    3900

    4000

    Folic acid (Folacin), mcg

    31

    34

    35

    Pantothenic acid, mcg

    920

    1150

    1190

    Biotin, mcg

    3.4

    3.9

    4

    Vitamin C (Ascorbic acid), mg

    15.2

    20

    21

    Minerals

         

    Calcium, mg

    116

    141

    145

    Phosphorus, mg

    63

    78

    80

    Magnesium, mg

    1.84

    5.1

    5.3

    Iron, mg

    1.76

    1.85

    1.91

    Zinc, mg

    0.96

    1.33

    1.37

    Manganese, mcg

    10

    10.4

    10.7

    Copper, mcg

    60

    98

    101

    Sodium, mg

    27

    55

    57

    Potassium, mg

    45

    95

    98

    Chloride, mg

    28

    86

    89

    *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.5

    Nutrient Density

    Per 4 Vials (30 Cal)

    Protein (% Calories)

    29

    Fat (% Calories)

    65

    Carbohydrate (% Calories)

    6

    Potential Renal Solute Load (mOsm/100 Calories)6

    33*

    Potential Renal Solute Load (mOsm/4 vials)6 Concentrate only

    17.7 per 4 vials

    Lactose-free

    No

     

    Per 1 Vial

    Per 4 Vials

    EHMFAL + Preterm Human Milk (1 Vial + 25 mL)

    Osmolality (mOsm/kg water)

    326

    pH

    ~4.3

    ~4.3

    ~4.7

    *When mixed at normal dilution, 1 vial to 25 mL preterm human milk.

    †31 mOsm/120 mL when 4 vials added to 100 mL preterm human milk.

    ‡When added to human milk as recommended, EHMFAL increases osmolality by approximately 36 mOsm/kg water.

    Pretermhuman milk caloric recipes

     

    NUTRIENTS PER 100 Cal

    ~Cal/fl oz

    22

    24

    Preterm human milk + EHMFAL Concentrate

    50 mL + 5 mL

    25 mL + 5 mL

    Final volume, mL

    55

    30

    Energy, Cal

    100

    100

    Protein, g

    3.3

    4

    Fat, g

    5.7

    6

    Carbohydrate, g

    9.3

    8.1

    Water, g

    118

    107

    Vitamins/Other Nutrients

       

    Vitamin A activity, IU

    770

    1250

    Vitamin D, IU

    124

    210

    Vitamin E, IU

    3.9

    6.2

    Vitamin K, mcg

    5.9

    7.9

    Thiamin (Vitamin B1), mcg

    123

    200

    Riboflavin (Vitamin B2), mcg

    191

    300

    Vitamin B6, mcg

    93

    151

    Vitamin B1, 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

    Vitamin C (Ascorbic acid), mg

    14.6

    21

    Carnitine, mg

    0.85

    0.72

    Taurine, mg

    4.9

    4.1

    Minerals

       

    Calcium, mg

    101

    145

    Phosphorus, mg

    56

    80

    Magnesium, mg

    5.1

    5.3

    Iron, mg

    1.18

    1.91

    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

    89

    Additional Nutrients

       

    Linoleic acid, mg

    730

    730

    Linolenic acid, mg

    54

    60

    ARA, mg

    32

    38

    DHA, mg

    21

    24

    NUTRIENTS PER 100 mL

    ~Cal/mL

    0.74

    0.81

    Preterm human milk + EHMFAL Concentrate

    50 mL + 5 mL

    25 mL + 5 mL

    Final volume, mL

    55

    30

    Energy, Cal

    75

    81

    Protein, g

    2.5

    3.2

    Fat, g

    4.2

    4.8

    Carbohydrate, g

    6.9

    6.6

    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

    143

    240

    Vitamin B6, mcg

    69

    122

    Vitamin B12, mcg

    0.31

    0.55

    Niacin, mcg

    1880

    3300

    Folic acid (Folacin), mcg

    17

    28

    Pantothenic acid, mcg

    630

    960

    Biotin, mcg

    2

    3.3

    Vitamin C (Ascorbic acid), mg

    10.9

    16.7

    Carnitine, mg

    0.64

    0.58

    Taurine, mg

    3.6

    3.3

    Minerals

       

    Calcium, mg

    75

    118

    Phosphorus, mg

    42

    65

    Magnesium, mg

    3.8

    4.3

    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

     

    Term human milk caloric recipes

    NUTRIENTS PER 100 Cal

    ~Cal/fl oz

    22

    24

    Term Human milk + EHMFAL Concentrate

    50 mL + 5 mL

    25 mL + 5 mL

    Final volume, mL

    55

    30

    Energy, Cal

    100

    100

    Protein, g

    2.4

    3.2

    Fat, g

    5.6

    6

    Carbohydrate, g

    10.1

    8.9

    Minerals, g

    0.57

    0.73

    Water, g

    118

    108

    Vitamins/Other Nutrients

       

    Vitamin A activity, IU

    880

    1350

    Vitamin D, IU

    116

    195

    Vitamin E, IU

    4.4

    6.6

    Vitamin K, mcg

    3.8

    6.2

    Thiamin (Vitamin B1), mcg

    136

    210

    Riboflavin (Vitamin B2), mcg

    220

    320

    Vitamin B6, mcg

    109

    165

    Vitamin B12, mcg

    0.48

    0.74

    Niacin, mcg

    2700

    4200

    Folic acid (Folacin), mcg

    32

    43

    Pantothenic acid, mcg

    830

    1190

    Biotin, mcg

    2.9

    4.2

    Vitamin C (Ascorbic acid), mg

    21

    26

    Choline, mg

    19.4

    16.5

    Inositol, mg

    32

    27

    Total nucleotides, mg

    3.4

    2.9

    Minerals

       

    Calcium, mg

    98

    143

    Phosphorus, mg

    54

    78

    Magnesium, mg

    5.1

    5.3

    Iron, mg

    1.14

    1.88

    Zinc, mg

    0.82

    1.2

    Manganese, mcg

    6.4

    10.6

    Copper, mcg

    73

    93

    Iodine, mcg

    18.2

    15.5

    Selenium, mcg

    2.4

    2.1

    Sodium, mg

    39

    47

    Potassium, mg

    85

    96

    Chloride, mg

    68

    73

    Additional Nutrients

       

    Linoleic acid, mg

    830

    820

    Linolenic acid, mg

    62

    67

    ARA, mg

    32

    38

    DHA, mg

    21

    24

    NUTRIENTS PER 100 mL

    ~Cal/mL

    0.74

    0.81

    Term Human milk + EHMFAL Concentrate

    50 mL + 5 mL

    25 mL + 5 mL

    Final volume, mL

    55

    30

    Energy, Cal

    75

    81

    Protein, g

    1.84

    2.6

    Fat, g

    4.2

    4.8

    Carbohydrate, g

    7.5

    7.2

    Minerals, g

    0.43

    0.59

    Water, g

    89

    88

    Vitamins/Other Nutrients

       

    Vitamin A activity, IU

    660

    1090

    Vitamin D, IU

    87

    158

    Vitamin E, IU

    3.3

    5.3

    Vitamin K, mcg

    2.8

    5

    Thiamin (Vitamin B1), mcg

    102

    167

    Riboflavin (Vitamin B2), mcg

    164

    260

    Vitamin B6, mcg

    82

    133

    Vitamin B12, mcg

    0.36

    0.6

    Niacin, mcg

    2000

    3400

    Folic acid (Folacin), mcg

    24

    35

    Pantothenic acid, mcg

    620

    960

    Biotin, mcg

    2.2

    3.4

    Vitamin C (Ascorbic acid), mg

    16

    21

    Choline, mg

    14.5

    13.3

    Inositol, mg

    24

    22

    Total nucleotides, mg

    2.5

    2.3

    Minerals

       

    Calcium, mg

    73

    116

    Phosphorus, mg

    41

    63

    Magnesium, mg

    3.8

    4.3

    Iron, mg

    0.85

    1.52

    Zinc, mg

    0.62

    0.97

    Manganese, mcg

    4.8

    8.6

    Copper, mcg

    55

    75

    Iodine, mcg

    13.6

    12.5

    Selenium, mcg

    1.82

    1.67

    Sodium, mg

    29

    38

    Potassium, mg

    64

    78

    Chloride, mg

    51

    59

    Additional Nutrients

       

    Linoleic acid, mg

    620

    670

    Linolenic acid, mg

    46

    54

    ARA, mg

    24

    31

    DHA, mg

    15.6

    19.2

     

    Product Forms and Ordering Information

    ENFAMIL HUMAN MILK FORTIFIER ACIDIFIED LIQUID IS AVAILABLE IN AN ULTRA-CONCENTRATED LIQUID

    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 Acidified Liquid, liquid
    Item #: 146301
    Description: Liquid
    Unit Size: 5 mL vial
    Calories/Unit: 7.5
    Product Yield/Unit (fl oz): 5 mL
    Case: 200 vials per case
    HCPCS Code: B4155
    NDC Format Code: 00087-1463-41

    PRODUCT BENEFITS

    Enfamil Human Milk Fortifier Acidified Liquid is clinically proven to support development and promote growth, including linear growth*1

    • Helps premature infants achieve significantly higher achieved weight, length, head circumference and linear growth rate than Enfamil Human Milk Fortifier Powder with the same volume intake1
    • 4 g of protein per 100 Cal when mixed with preterm human milk
    • Protein source is partially hydrolyzed whey protein
    • ~21% more protein than Enfamil Human Milk Fortifier Powder
    • Shown to significantly improve DHA and ARA status in preterm infants compared to Enfamil Human Milk Fortifier Powder2

    Clinically proven safe and well tolerated in preterm infants‡1,3,4

    • No statistical differences in confirmed NEC (3%), sepsis (12%) or serious adverse events than Enfamil HMF Powder1
    • Commercially sterile, single-dose packaging meets AND and CDC feeding preparation guidelines

    *Based on the gold standard for clinical research: randomized, prospective, blinded, controlled clinical trials.

    †When mixed as directed: EHMFAL + preterm human milk (1 vial + 25 mL).

    ‡Studies used EHMFAL vs. Enfamil HMF Powder.

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    References

    1. Moya F, Sisk PM, Walsh KR, et al. A new liquid human milk fortifier and linear growth in preterm infants. 2012;130:e928-e935.
    2. Berseth CL, Harris CL, Wampler JL, et al. Liquid human milk fortifier significantly improves docosahexaenoic and arachidonic acid status in preterm infants. Prostaglandins Leukot Essent Fatty Acids.2014;91:97-103.
    3. Kurada S, Kamat M, Khilfeh M, et al. Comparison of breast milk with powdered human milk fortifier (PHMF) and Liquid Human Milk Fortifier (LHMF) on nutrition and growth parameters of VLBW infants. Presented at: Pediatric Academic Societies Annual Meeting; May 3-6, 2014; Vancouver, Canada. Abstract 3845.687.
    4. Mayberry L, Wolf S. Tracking nutritional protein management in the preterm infant using Vermont-Oxford benchmarks. FASEB J.2014;28(1 suppl):LB318.
    5. Data on file, Mead Johnson Nutrition, September 7, 2010.
    6. Fomon SJ, Ziegler EE. Renal solute load and potential renal solute in infancy. J Pediatr. 1999;134:11-14.