BackgroundInfrared (IR) analysis is an emerging technology that may be a useful tool for milk banks to manage the nutrient variability in donor human milk.ObjectiveTo evaluate the accuracy, reliability, and comparability of commercial infrared analyzers for measuring human milk macronutrients in a milk bank setting.MethodsThree nonprofit milk banks received blinded test kits of human milk that had been assessed using reference methods. Four infrared instruments were used to measure macronutrients as follows: 1 filtered mid-IR, 2 Fourier-transformed full-spectra mid-IR, and 1 near-IR. Twenty-five unique samples were read concurrently for the accuracy arm. An identical sample was read daily for 1 mo for the reliability arm.ResultsValues for R2 describing relationships with reference methods for total fat, crude protein, and lactose, were as follows: filtered mid-IR, 0.98, 0.94, and 0.48; Fourier-transformed full-spectra mid-IR, 0.97, 0.93, and 0.36 for instrument 1 and 0.98, 0.98, and 0.31 for instrument 2; and near-IR 0.93, 0.93, and 0.12. There was no significant difference between instruments for crude protein and total fat measurements. There were significant differences in carbohydrate measurements between instruments. For 1 mo of daily measurements in the reliability arm, CVs for filtered mid-IR were ≤4.6%, for Fourier-transformed full spectra mid-IR were ≤1.7%, and for near-IR were ≤5.1%.ConclusionsInfrared analysis is an accurate and reliable method for measuring crude protein and total fat in a milk bank setting. Carbohydrate measurements are less accurate and are significantly different between instruments, which will likely lead to differences in derived calorie values.

Human breast milk provides nutritional and medicinal benefits that are important to infants, particularly those who are premature or ill. Donor human milk, collected, processed, and dispensed via milk banks, is the standard of care for infants in need whose mothers cannot provide an adequate supply of milk. In this paper, we focus on streamlining donor human milk processing at nonprofit milk banks. On days that milk is processed, milk banks thaw frozen deposits, pool together milk from multiple donors to meet nutritional specifications of predefined milk types, bottle and divide the pools into batches, and pasteurize the batches using equipment with various degrees of labor requirements. Limitations in staffing and equipment and the need to follow strict healthcare protocols require productive, expedient, and frugal pooling strategies. We formulate integer programs that optimize the batching-pasteurizing decisions and the integrated pooling-batching-pasteurizing decisions by minimizing labor and meeting target production goals. We further strengthen these formulations by establishing valid inequalities for the integrated model. Numerical results demonstrate a reduction in the optimality gap through the strengthened formulation versus the basic integer programming formulation. A case study at Mothers’ Milk Bank of North Texas demonstrates significant improvement in meeting milk type production targets and a modest reduction in labor compared with former practice. The model is in use at Mothers’ Milk Bank of North Texas and has effectively improved their production balance across different milk types.