Human milk analyser underestimated protein content of unfortified and fortified samples compared to elemental analysis

Thajer, Alexandra; Fusch, Gerhard; Binder, Christoph J.; Berger, Angelika; Fusch, Christoph

doi:10.1111/apa.14982

Cited by 3 publications

(5 citation statements)

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“…This might be the reason why Vieira et al indicated a 4% protein reduction after HM pasteurization [ 45 ]. However, the results of the current study show that pasteurization had no impact on the HM protein content, which is in line with results previously published in the literature [ 46 , 47 , 48 ]. Valentine et al analyzed the amino acid levels in HM and did not find significant differences before and after pasteurization [ 49 ].…”

Section: Discussionsupporting

confidence: 93%

“…Our method used in the milk kitchen seemed to not accelerate the heat-induced denaturation and aggregation of whey proteins. However, the following factors, such as temperature, duration, and the method of pasteurization, might have had an impact on the findings [ 46 ]. Moreover, another study assessed that HM processing did not affect protein concentrations or any other HM nutrient but had an impact on osmolarity and should be especially considered in combination with fortification steps performed in preterm infants [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

“…A strength of this study was the sample size compared to previous studies [ 46 , 51 , 52 , 72 ]. The collection, processing, and analysis of the HM were standardized in order to ensure comparability across all samples.…”

Section: Discussionmentioning

confidence: 99%

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Human Milk Processing and Its Effect on Protein and Leptin Concentrations

et al. 2023

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(1) Background: For the storage of human milk (HM), freezing, thawing, and/or pasteurization are routinely used in neonatal intensive care units. We aimed to analyze the effects of different HM processing types on the nutritional contents in HM, adipose tissue, and the neuroprotection markers leptin and adiponectin. (2) Methods: HM samples from 136 mothers of preterm and term infants (gestational age 23 + 0 to 41 + 6) were collected and divided into four groups: (i) fresh HM, (ii) fresh pasteurized HM, (iii) thawed HM, and (iv) thawed pasteurized HM. The macronutrients were analyzed by mid-infrared transmission spectroscopy and the adiponectin and leptin were analyzed by high-sensitivity adiponectin and leptin enzyme-linked immunosorbent assay (ELISA). (3) Results: No significant differences were observed in the protein, carbohydrate, or fat concentrations between the HM processing types. The leptin levels were significantly lower after pasteurization in comparison to HM without pasteurization (p < 0.001). The protein levels in extremely preterm HM were significantly lower compared to those in moderate/late preterm HM and term HM (p < 0.05). (4) Conclusions: HM processing had an impact on leptin concentrations but no effect on the protein level. These data support the use of unpasteurized human milk for preterm infants’ nutrition and normal brain development. The protein levels of the milk of mothers from preterm compared to full-term infants differed, underlining the importance of individualized target fortification.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Human Milk Processing and Its Effect on Protein and Leptin Concentrations

et al. 2023

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“…We did not record diet history for mothers or donors, and this will be an additional measure in the future along with the measurement of milk carotenoids. Finally, we used the midinfrared HMA as the gold standard, which may slightly underestimate the protein content and overestimate the carbohydrate content [52].…”

Section: Discussionmentioning

confidence: 99%

Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants

et al. 2023

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Fixed-dose fortification of human milk (HM) is insufficient to meet the nutrient requirements of preterm infants. Commercial human milk analyzers (HMA) to individually fortify HM are unavailable in most centers. We describe the development and validation of a bedside color-based tool called the ‘human milk calorie guide’(HMCG) for differentiating low-calorie HM using commercial HMA as the gold standard. Mothers of preterm babies (birth weight ≤ 1500 g or gestation ≤ 34 weeks) were enrolled. The final color tool had nine color shades arranged as three rows of three shades each (rows A, B, and C). We hypothesized that calorie values for HM samples would increase with increasing ‘yellowness’ predictably from row A to C. One hundred thirty-one mother’s own milk (MOM) and 136 donor human milk (DHM) samples (total n = 267) were color matched and analyzed for macronutrients. The HMCG tool performed best in DHM samples for predicting lower calories (<55 kcal/dL) (AUC 0.87 for category A DHM) with modest accuracy for >70 kcal/dL (AUC 0.77 for category C DHM). For MOM, its diagnostic performance was poor. The tool showed good inter-rater reliability (Krippendorff’s alpha = 0.80). The HMCG was reliable in predicting lower calorie ranges for DHM and has the potential for improving donor HM fortification practices.

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“…One study found that the accuracy of using MIR to determine protein and fat in human milk is about 60 − 70% [17]. Another study reported that the MIR method could underestimate protein content in human breast milk [47]. Other studies have shown that the MIR method could be used to determine the macronutrients in cow's milk and predict other characteristics of dairy products (such as various fatty acids, milk protein composition and structure, curd characteristics, titrated acidity, and potential diseases) [48][49][50][51].…”

Section: Discussionmentioning

confidence: 99%

Comparing human milk macronutrients measured using analyzers based on mid-infrared spectroscopy and ultrasound and the application of machine learning in data fitting

Ruan

Tang

Zhang

et al. 2022

BMC Pregnancy Childbirth

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Objective Fat, carbohydrates (mainly lactose) and protein in breast milk all provide indispensable benefits for the growth of newborns. The only source of nutrition in early infancy is breast milk, so the energy of breast milk is also crucial to the growth of infants. Some macronutrients composition in human breast milk varies greatly, which could affect its nutritional fulfillment to preterm infant needs. Therefore, rapid analysis of macronutrients (including lactose, fat and protein) and milk energy in breast milk is of clinical importance. This study compared the macronutrients results of a mid-infrared (MIR) analyzer and an ultrasound-based breast milk analyzer and unified the results by machine learning. Methods This cross-sectional study included breastfeeding mothers aged 22–40 enrolled between November 2019 and February 2021. Breast milk samples (n = 546) were collected from 244 mothers (from Day 1 to Day 1086 postpartum). A MIR milk analyzer (BETTERREN Co., HMIR-05, SH, CHINA) and an ultrasonic milk analyzer (Honɡyanɡ Co,. HMA 3000, Hebei, CHINA) were used to determine the human milk macronutrient composition. A total of 465 samples completed the tests in both analyzers. The results of the ultrasonic method were mathematically converted using machine learning, while the Bland-Altman method was used to determine the limits of agreement (LOA) between the adjusted results of the ultrasonic method and MIR results. Results The MIR and ultrasonic milk analyzer results were significantly different. The protein, fat, and energy determined using the MIR method were higher than those determined by the ultrasonic method, while lactose determined by the MIR method were lower (all p < 0.05). The consistency between the measured MIR and the adjusted ultrasound values was evaluated using the Bland-Altman analysis and the scatter diagram was generated to calculate the 95% LOA. After adjustments, 93.96% protein points (436 out of 465), 94.41% fat points (439 out of 465), 95.91% lactose points (446 out of 465) and 94.62% energy points (440 out of 465) were within the LOA range. The 95% LOA of protein, fat, lactose and energy were - 0.6 to 0.6 g/dl, -0.92 to 0.92 g/dl, -0.88 to 0.88 g/dl and - 40.2 to 40.4 kj/dl, respectively and clinically acceptable. The adjusted ultrasonic results were consistent with the MIR results, and LOA results were high (close to 95%). Conclusions While the results of the breast milk rapid analyzers using the two methods varied significantly, they could still be considered comparable after data adjustments using linear regression algorithm in machine learning. Machine learning methods can play a role in data fitting using different analyzers.

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Human milk analyser underestimated protein content of unfortified and fortified samples compared to elemental analysis

Cited by 3 publications

References 5 publications

Human Milk Processing and Its Effect on Protein and Leptin Concentrations

Human Milk Processing and Its Effect on Protein and Leptin Concentrations

Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants

Comparing human milk macronutrients measured using analyzers based on mid-infrared spectroscopy and ultrasound and the application of machine learning in data fitting

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