Adequacy of human milk viscosity to respond to infants with dysphagia: experimental study

Abstract

Neonatal nutrition is an important subject in health in the short, medium and long term. In preterm newborns, nutrition assumes a predominant role for the child's overall development. Babies with uncoordinated swallowing or respiration may not have the necessary oral abilities to suck the mother's breast and will need to implement different feeding practices; one of them is changing the consistency of the milk offered.ObjectivesDetermine viscosity variations of untreated human and pasteurized milk without and with thickening to adapt the diet to the needs of dysphagic infants hospitalized in the Neonatal Intensive Cara Unit (NICU). Material and MethodsThe authors altered the viscosity of natural infant powdered milk and, after thickening, determined and adopted a thickening standard for human milk. Untreated human and pasteurized milk was thickened in concentrations of 2%, 3%, 5% and 7% and the viscosity were determined every 20 minutes for a period of 60 minutes at a temperature of 37ºC. ResultsThe infant lactose formula thickened at concentrations of 2% and 3% produced viscosities of 8.97cP and 27.73 cP, respectively. The increases were significantly different after 1 hour. Inversely, untreated human milk at 2%, 3%, 5% and 7% produced diminished viscosity over time; the changes were more accentuated in the first 20 minutes. In pasteurized human milk, the 2% concentration had no variation in viscosity, but with the 3%, 5% and 7% concentrations, there was a significant decrease in the first 20 minutes with stability observed in the subsequent times. ConclusionIn powdered milk, the viscosity increases over time; the viscosity in human milk diminishes. The results point out the importance not only of considering the concentration of the thickener but also the time being administered after its addition to effectively treat dysphagic infants.

Comparative Analysis of the Physicochemical Parameters of Breast Milk, Starter Infant Formulas and Commercial Cow Milks in Serbia

“…Viscosity is an important rheological property of breast milk because it determines the ease of swallowing by infants. There are few recent data about the viscosity of human milk (15,16).…”

Study on viscosity modification of human and formula milk for infants with dysphagia

“…An increase in the viscosity of milk formula samples was observed from 3% onwards, and higher viscosity values were observed compared to human milk with the same thickener concentration. This can be explained by the presence of amylase enzyme in human milk, which, even after pasteurization, can cause partial hydrolysis of the starch and consequently, a decrease in viscosity 13 . This effect positively correlated with increased concentration.…”

“…In view of the recommendations from new studies 12 , and the results reported by Almeida et al 13 , who demonstrated a significant change in viscosity and time with maize starch and maltodextrin as thickening agents, we decided to evaluate whether rice cereal would be more stable when added to human milk and milk formula. The results showed that the viscosity of human milk and formula remained stable for 1 hour since the use of a rice cereal-thickening agent.…”

“…The concentration of 7% was not analyzed for the formula because its viscosity made it impossible to pass through orifice 2. The process of determining the viscosity of human milk using the Ford Cup has been previously described 13 .…”

“…For newborns, the diet has a thin consistency, which requires greater control of the proprioception, organization, and coordination between suction, breathing and swallowing. Diet with modified viscosity favors coordination between the processes of suction, breathing, and swallowing, and, therefore, the baby is better prepared for swallowing 12. A study by Almeida et al 13 showed different results for viscosity depending on the type of milk used. The thickening agent used was cornstarch with maltodextrin.…”