Energy and Fat Intake for Preterm Infants Fed Donor Milk Is Significantly Impacted by Enteral Feeding Method

Castro, Maria del Carmen; Asbury, Michelle R.; Shama, Sara; Stone, Debbie; Yoon, Eugene W.; O'Connor, Deborah L; Unger, Sharon

doi:10.1002/jpen.1430

Cited by 14 publications

(7 citation statements)

References 13 publications

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“…Several studies have addressed the effect of this type of pasteurization on milk macronutrients, reporting no differences in the protein and lactose content between raw and HoP-treated DHM [5]. In relation to fat, some authors found up to a 25% reduction in fat concentration in DHM after HoP when compared to that in untreated DHM [25], while others reported no significant differences between pre-and post-HoP-treated DHM [26]. In our study, the mean protein concentration in HoP-treated DHM was 0.2 g/L lower than that in raw DHM, but there was no difference in lactose and fat levels.…”

Section: Discussionmentioning

confidence: 99%

High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

Escuder-Vieco¹,

Rodríguez

Espinosa-Martos³

et al. 2021

Life

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Holder pasteurization (HoP; 62.5 °C, 30 min) is commonly used to ensure the microbiological safety of donor human milk (DHM) but diminishes its nutritional properties. A high-temperature short-time (HTST) system was designed as an alternative for human milk banks. The objective of this study was to evaluate the effect of this HTST system on different nutrients and the bile salt stimulated lipase (BSSL) activity of DHM. DHM was processed in the HTST system and by standard HoP. Macronutrients were measured with a mid-infrared analyzer. Lactose, glucose, myo-inositol, vitamins and lipids were assayed using chromatographic techniques. BSSL activity was determined using a kit. The duration of HTST treatment had a greater influence on the nutrient composition of DHM than did the tested temperature. The lactose concentration and the percentage of phospholipids and PUFAs were higher in HTST-treated than in raw DHM, while the fat concentration and the percentage of monoacylglycerides and SFAs were lower. Other nutrients did not change after HTST processing. The retained BSSL activity was higher after short HTST treatment than that following HoP. Overall, HTST treatment resulted in better preservation of the nutritional quality of DHM than HoP because relevant thermosensitive components (phospholipids, PUFAs, and BSSL) were less affected.

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Section: Discussionmentioning

confidence: 99%

High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

Escuder-Vieco¹,

Rodríguez

Espinosa-Martos³

et al. 2021

Life

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“…It is well established that bolus feedings yield smaller fat losses than continuous feedings [8][9][10][12][13][14]; nevertheless, continuous feedings are still used in NICUs. Continuous feeding seems to be better than intermittent feeding with regard to gastrointestinal tolerance in VLBW [15]; bolus-fed infants had a significantly higher risk of behavioral stress response [16], and continuous feeding has been shown to lead to infants reaching total enteral feeding faster and significantly faster lower leg growth rate as compared with bolus-fed infants [15].…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Breast Milk Fat Loss during Administration in the Neonatal Intensive Care Unit

2021

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The objective of this study was to investigate factors influencing fat loss during tube feeding of breast milk to preterm infants. An experimental study with 81 feeding simulations was performed, with nine continuous infusions in each of six modalities: Horizontal Higher, Horizontal Matched, Horizontal Lower, Tilted Higher, Tilted Matched, and Tilted Lower, and for comparison, 27 bolus feedings: nine flushed with air, nine with water, and nine that were not flushed, done at matched height. Each simulation utilized 16 mL of breast milk given over four hours. Continuous infusions were given with a flow rate of 4 mL/h. Bolus was given as 8 mL over the course of 15–20 min every other hour. Analysis for fat, true protein, carbohydrate, total solids, and energy was performed before and after each simulation. The percent of macronutrient loss was compared between all simulations. Continuous infusion resulted in an average fat loss of 40%. Bolus feedings resulted in an average fat loss of 11% (p ≤ 0.001). Considerable fat loss is seen during continuous tube feeding. Neither height in relation to the infant nor tilting of the pump reduce fat loss. To limit fat loss, the bolus feeding method should be utilized.

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“…This might explain why the growth rate of preterm infants fed with pooled full-term DM is slow. Marina showed that pasteurization did not significantly reduce the macro-nutrients and energy content of DM, but slower milk infusion rates significantly impacted the final delivery of fat and energy ( 10 ). All of these findings imply that the screening of DM is the key: The mothers of preterm infants should be prioritized as donors.…”

Section: Discussionmentioning

confidence: 99%

Is preterm donor milk better than preterm formula for very-low-birth-weight infants?

Fang

Zhang

et al. 2021

Food & Nutrition Research

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Background: Preterm human milk has advantages over preterm formula (PF), but it may compromise some functions after pasteurization. Objective: To explore the effects of preterm donor milk (DM) on growth, feeding tolerance, and severe morbidity in very-low-birth-weight infants. Method: This was a single-center, prospective cohort study that included 304 preterm infants weighing <1,500 g or of gestational age <32 weeks. If the mother’s own milk was insufficient, the parents decided to use PF (n = 155) or DM (n = 149). The two groups were uniformly managed according to the standard NICU protocol. Growth parameters, feeding tolerance, and severe morbidity such as necrotizing enterocolitis, were compared between the two groups. Results: The daily weight gain and weekly head growth in the DM group were not different from those in the PF group (P > 0.05). Feeding intolerance in the DM group was significantly lower than that in PF group (P < 0.05), and parenteral nutrition time and hospitalization time were also shorter than that in the PF group (P < 0.05). Moreover, the incidence of necrotizing enterocolitis and sepsis was also significantly lower in the DM group (P < 0.05). Conclusion: The study indicated that preterm DM does not affect the growth of very-low-birth-weight infants. Further, it significantly reduces feeding intolerance, helps achieve full enteral feeding early, and has protective effects against necrotizing enterocolitis and sepsis. Thus, compared with formula, preterm DM can lower the rate of infection in preterm infants and is worthy of promotion.

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Energy and Fat Intake for Preterm Infants Fed Donor Milk Is Significantly Impacted by Enteral Feeding Method

Abstract: Pasteurization did not significantly reduce donor milk macronutrient and energy content; however, feeding method significantly impacted the final delivery of energy and fat.

Cited by 14 publications

References 13 publications

High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

Factors Influencing Breast Milk Fat Loss during Administration in the Neonatal Intensive Care Unit

Is preterm donor milk better than preterm formula for very-low-birth-weight infants?

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