Accuracy and Reliability of Infrared Analyzers for Measuring Human Milk Macronutrients in a Milk Bank Setting

Perrin, Maryanne T.; Festival, Jannette; Starks, Shaina; Mondeaux, Lesley; Brownell, Elizabeth A.; Vickers, Amy

doi:10.1093/cdn/nzz116

Cited by 19 publications

(18 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most common analytical method used for measuring macronutrients in the studies reviewed was infrared analysis. A growing body of evidence suggests that infrared analysis can reliably measure total nitrogen (e.g., crude protein) and fat in human milk, with appropriate sample handling and instrument calibration, though measurements of lactose were less accurate, and the measurement of total carbohydrates in human milk has not been validated (36)(37)(38)(39)(40)(41)(42) . None of the reviewed studies used reference methods suggested by the USDA (8) to measure total protein or total fat, and only 1 study used reference methods for measuring lactose, which limits the ability to draw conclusions about actual nutrient ranges.…”

Section: Methodsmentioning

confidence: 99%

The Nutritional Composition and Energy Content of Donor Human Milk: A Systematic Review

Perrin

Belfort

Hagadorn

et al. 2020

Advances in Nutrition

Self Cite

View full text Add to dashboard Cite

The American Academy of Pediatrics recommends donor human milk (DHM) as the preferred feeding strategy for preterm infants when the milk of the mother is unavailable, based on conclusive evidence of lower rates of necrotizing enterocolitis with DHM feedings compared with preterm infant formula. The nutritional composition of DHM may differ from maternal milk for many reasons including differences in maternal characteristics, milk collection methods, and the impact of donor milk banking practices. The purpose of this systematic review is to examine the literature regarding research on the fat, protein, carbohydrate, vitamin, and mineral composition of DHM obtained through nonprofit milk banks or commercial entities. PubMed, CINAHL, and Scopus databases were searched for articles published between 1985 and 30 April, 2019. In total, 164 abstracts were screened independently by 2 investigators, and 14 studies met all inclusion criteria. Studies were predominantly small (<50 samples) and measured macronutrients. Few studies assessed vitamins and minerals. Information bias was prevalent due to the use of a variety of analytical methods which influence accuracy and cross-study comparisons. Other sources of information bias included missing information regarding methods for protein and calorie assessment. Despite these limitations, existing research suggests the potential for 2-fold and greater differences in the fat, protein, and energy composition of DHM, with mean values for energy and fat often below clinical reference values expected for human milk. Further research is warranted regarding the nutritional composition of DHM, with a prioritization on measuring macronutrients and micronutrients using established reference methods.

show abstract

Section: Methodsmentioning

confidence: 99%

The Nutritional Composition and Energy Content of Donor Human Milk: A Systematic Review

Perrin

Belfort

Hagadorn

et al. 2020

Advances in Nutrition

Self Cite

View full text Add to dashboard Cite

show abstract

“…For example, ultra-high-performance LC–tandem MS (UHPLC–MS/MS) and inductively coupled plasma–atomic emission spectrometry coupled with a mass spectrometer (ICP–MS) are now optimized for the analysis of a panel of B vitamins (vitamin B-1, B-2, B-3, and B-6) and minerals (iron, copper, zinc, iodine, calcium, and magnesium), respectively ( 75 , 76 ). Also, a human-milk analyzer based on mid- and near-infrared spectroscopy has been developed to simultaneously measure all macronutrients ( 77 , 78 ).…”

Section: Advances and Technologies For Human-milk Analysismentioning

confidence: 99%

The need to study human milk as a biological system

Christian

Smith

Lee

et al. 2021

The American Journal of Clinical Nutrition

127

View full text Add to dashboard Cite

Critical advancement is needed in the study of human milk as a biological system that intersects and interacts with myriad internal (maternal biology) and external (diet, environment, infections) factors and its plethora of influences on the developing infant. Human-milk composition and its resulting biological function is more than the sum of its parts. Our failure to fully understand this biology in a large part contributes to why the duration of exclusive breastfeeding remains an unsettled science (if not policy). Our current understanding of human-milk composition and its individual components and their functions fails to fully recognize the importance of the chronobiology and systems biology of human milk in the context of milk synthesis, optimal timing and duration of feeding, and period of lactation. The overly simplistic, but common, approach to analyzing single, mostly nutritive components of human milk is insufficient to understand the contribution of either individual components or the matrix within which they exist to both maternal and child health. There is a need for a shift in the conceptual approach to studying human milk to improve strategies and interventions to support better lactation, breastfeeding, and the full range of infant feeding practices, particularly for women and infants living in undernourished and infectious environments. Recent technological advances have led to a rising movement towards advancing the science of human-milk biology. Herein, we describe the rationale and critical need for unveiling the multifunctionality of the various nutritional, nonnutritional, immune, and biological signaling pathways of the components in human milk that drive system development and maturation, growth, and development in the very early postnatal period of life. We provide a vision and conceptual framework for a research strategy and agenda to change the field of human-milk biology with implications for global policy, innovation, and interventions.

show abstract

“…Recent research has shown that a variety of infrared analyzers are reliable and accurate for measuring fat and protein in a milk bank setting. 32 Fu et al 8 examined the macronutrients in target pooled DHM from one milk bank and reported fat values from 1.5 to 4.5 g/dL, and protein values from 0.3 to 1.4 g/dL. In our study, we observed higher minimum values in target pooled milk (2.6 g/dL for fat and 0.8 g/dL for protein) than those reported by Fu et al These differences may be related to sample collection protocol.…”

Section: Impact Of Target Poolingmentioning

confidence: 99%

Fat and Protein Variability in Donor Human Milk and Associations with Milk Banking Processes

Friend

Perrin

2020

Breastfeeding Medicine

View full text Add to dashboard Cite

Background:The impact of milk banking processes on macronutrient variability in donor human milk (DHM) is largely unknown. Objective: To gain a better understanding of fat and protein composition in DHM and assess potential relationships with modifiable milk bank processes. Methods: Samples of raw, pooled DHM were collected from 20 milk banks (n = 300) along with the following processing attributes: if macronutrient analysis was used to select donors for pooling (target pooling; yes/no), number of donors per pool, pooling container material (glass/plastic/other), and method for mixing during bottling (manual/mechanical). Fat and protein were assessed. Homoscedasticity was assessed and magnitude of the spread was quantified. Results: Fat ranged from 1.9 to 6.1 g/dL (n = 298) and protein ranged from 0.7 to 1.4 g/dL (n = 300). Variability in fat was significantly lower in samples that had been target pooled (p = 0.04), contained more donors per pool (p < 0.001), and had been mixed mechanically (p < 0.001). Variability in protein was significantly lower in samples that contained more donors per pool (p = 0.001). In a stratified analysis, increasing the number of donors per pool only reduced nutrient variability in samples that were not target pooled. Conclusion: For milk banks that do not target pool, using a greater number of donors in a pool may reduce fat and protein variability.

show abstract

Accuracy and Reliability of Infrared Analyzers for Measuring Human Milk Macronutrients in a Milk Bank Setting

Cited by 19 publications

References 34 publications

The Nutritional Composition and Energy Content of Donor Human Milk: A Systematic Review

The Nutritional Composition and Energy Content of Donor Human Milk: A Systematic Review

The need to study human milk as a biological system

Fat and Protein Variability in Donor Human Milk and Associations with Milk Banking Processes

Contact Info

Product

Resources

About