Comparison of macronutrient content in human milk measured by mid-infrared human milk analyzer and reference methods

Giuffrida, Francesca; Austin, Sean; Cuany, Denis; Sanchez-Bridge, Belén; Longet, Karin; Bertschy, Emmanuelle; Sauser, Julien; Thakkar, Sagar K.; Lee, Le Ye; Affolter, Michael

doi:10.1038/s41372-018-0291-8

Cited by 25 publications

(19 citation statements)

References 19 publications

(29 reference statements)

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“…Total lipids was measured by MIRIS ® HMA as previously described by Giuffrida et al [23] and results are listed in Table 2. Total lipids content increased from colostrum (2.4 and 1.7 g/100 mL preterm and term HM, respectively) to mature milk (3.1 and 3.6 g/100 mL in preterm and term HM, respectively).…”

Section: Resultsmentioning

confidence: 99%

Temporal Progression of Fatty Acids in Preterm and Term Human Milk of Mothers from Switzerland

et al. 2019

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We longitudinally compared fatty acids (FA) from human milk (HM) of mothers delivering term and preterm infants. HM was collected for 4 months postpartum at 12 time points for preterm and for 2 months postpartum at 8 time points for term group. Samples were collected from the first feed of the morning, and single breast was fully expressed. FA were analyzed by gas chromatography coupled with flame ionization detector. Oleic, palmitic and linoleic acids were the most abundant FA across lactation and in both groups. Preterm colostrum contained significantly (p < 0.05) higher 8:0, 10:0, 12:0, sum medium chain fatty acids (MCFA), 18:3 n-3 FA compared to term counterparts. Preterm mature milk contained significantly higher 12:0, 14:0, 18:2 n-6, sum saturated fatty acids (SFA), and sum MCFA. We did not observe any significant differences between the preterm and term groups for docosahexaenoic acid, arachidonic acid and eicosapentaenoic acid at any stage of lactation. Overall, preterm milk was higher for SFA with a major contribution from MCFA and higher in 18:2 n-6. These observational differences needs to be studied further for their implications on preterm developmental outcomes and on fortification strategies of either mothers’ own milk or donor human milk.

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Section: Resultsmentioning

confidence: 99%

Temporal Progression of Fatty Acids in Preterm and Term Human Milk of Mothers from Switzerland

et al. 2019

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“…This work has some limitations to consider: (i) as mentioned above, the method of sampling (first milk of the morning rather than pooled over 24 h) could have increased the measured variations, especially for lipids; (ii) variations in milk volumes, that may have also contributed to the important variability observed, were not recorded and thus could not be taken into account; (iii) the method of measuring macronutrients (MIRIS ©) is a method whose reliability is open to criticism [46]. We attempted to enhance its accuracy through validation methods and protein correction strategy [31]; (iv) finally, the small number of patients in each group limited the power of the study, and allowed only a limited number of associated factors to be analyzed. However, the influence of other factors, such as intrauterine growth restriction, twinning, antenatal steroids, smoking, and maternal comorbidities, for example, also deserves to be further investigated.…”

Section: Discussionmentioning

confidence: 99%

“…We used a MIRIS measure validation process that had been previously published [31]. As in other literature reports, this validation showed that the MIRIS was not accurate enough for the measurement of total protein in human milk as compared with the Kjeldahl reference method (AOAC International, method number 991.22), while no differences were observed for fat and carbohydrate content as compared with the corresponding reference methods.…”

Section: Methodsmentioning

confidence: 96%

Longitudinal Analysis of Macronutrient Composition in Preterm and Term Human Milk: A Prospective Cohort Study

et al. 2019

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Background: Mother’s own milk is the optimal source of nutrients and provides numerous health advantages for mothers and infants. As they have supplementary nutritional needs, very preterm infants may require fortification of human milk (HM). Addressing HM composition and variations is essential to optimize HM fortification strategies for these vulnerable infants. Aims: To analyze and compare macronutrient composition in HM of mothers lactating very preterm (PT) (28 0/7 to 32 6/7 weeks of gestational age, GA) and term (T) infants (37 0/7 to 41 6/7 weeks of GA) over time, both at similar postnatal and postmenstrual ages, and to investigate other potential factors of variations. Methods: Milk samples from 27 mothers of the PT infants and 34 mothers of the T infants were collected longitudinally at 12 points in time during four months for the PT HM and eight points in time during two months for the T HM. Macronutrient composition (proteins, fat, and lactose) and energy were measured using a mid-infrared milk analyzer, corrected by bicinchoninic acid (BCA) assay for total protein content. Results: Analysis of 500 HM samples revealed large inter- and intra-subject variations in both groups. Proteins decreased from birth to four months in the PT and the T HM without significant differences at any postnatal time point, while it was lower around term equivalent age in PT HM. Lactose content remained stable and comparable over time. The PT HM contained significantly more fat and tended to be more caloric in the first two weeks of lactation, while the T HM revealed higher fat and higher energy content later during lactation (three to eight weeks). In both groups, male gender was associated with more fat and energy content. The gender association was stronger in the PT group, and it remained significant after adjustments. Conclusion: Longitudinal measurements of macronutrients compositions of the PT and the T HM showed only small differences at similar postnatal stages in our population. However, numerous differences exist at similar postmenstrual ages. Male gender seems to be associated with a higher content in fat, especially in the PT HM. This study provides original information on macronutrient composition and variations of HM, which is important to consider for the optimization of nutrition and growth of PT infants.

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“…Several investigators have evaluated the MIRIS HMA, with variable and conflicting results in precision and accuracy compared with reference biochemical macronutrient determination techniques (24)(25)(26)(27)(28)(29) . Many studies have demonstrated good precision with the MIRIS HMA in fat and protein but not in lactose determination (25,26,28) ; this may be due to the presence of oligosaccharides in significant numbers in human milk which cannot be differentiated from lactose by the IR technology (30,31) .…”

Section: Milk Analysismentioning

confidence: 99%

Macronutrient content of donor milk from a regional human milk bank: variation with donor mother–infant characteristics

Mills

Coulter²,

Savage³

et al. 2019

Br J Nutr

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Better understanding of the variation in macronutrient content of human donor milk (HDM) potentiates targeted nutrition for preterm babies. The present study describes the relationship of maternal age, parity, monthly lactation stage estimate (LSEm), daily volume of milk expressed (Vd), sex, gestation and birth weight z scores with macronutrient content of HDM. Multilevel mother–infant pair ID random intercept models were performed using the predictor variables above on the outcome HDM macronutrient content determined using mid-IR spectroscopy. Mean macronutrient content was also compared by gestational age and small for gestational age (SGA) (z score < –1·28) or appropriate for gestational age (AGA) (z score ≥ –1·28) categories. A total of 2966 samples of donations from 1175 mother–infant pairs to the UK Northwest Human Milk Bank between 2011 and 2017 were analysed. Mean protein, fat, carbohydrate and calculated energy were 0·89 (SD 0·24) g/dl, 2·99 (SD 0·96) g/dl, 7·09 (SD 0·44) g/dl, and 60·37 (SD 8·41) kcal/dl (252·59 (SD 35·19) kJ/dl), respectively. Preterm SGA HDM was significantly higher in protein, fat and energy content than term AGA HDM and significantly lower in carbohydrate content than term AGA HDM after controlling for LSEm, Vd and between-subject effects. Degree of prematurity did not influence macronutrient content. Between-subject effects accounted for more of the variance in macronutrient content than the fixed effects in the model. Despite this, SGA status, as well as prematurity, may be an important determinant of macronutrient content in human milk. As bioavailability of macronutrients from HDM is uncertain, studies evaluating growth and body composition in preterm and SGA babies fed HDM are warranted.

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Comparison of macronutrient content in human milk measured by mid-infrared human milk analyzer and reference methods

Cited by 25 publications

References 19 publications

Temporal Progression of Fatty Acids in Preterm and Term Human Milk of Mothers from Switzerland

Temporal Progression of Fatty Acids in Preterm and Term Human Milk of Mothers from Switzerland

Longitudinal Analysis of Macronutrient Composition in Preterm and Term Human Milk: A Prospective Cohort Study

Macronutrient content of donor milk from a regional human milk bank: variation with donor mother–infant characteristics

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