Human milk enriched with human milk lyophilisate for feeding very low birth weight preterm infants: A preclinical experimental study focusing on fatty acid profile

Abstract

BackgroundHuman milk, with essential nutrients and long chain polyunsaturated fatty acids (LC-PUFAs) such as the omega 3 and 6 fatty acids is important for development of the central nervous system and the retina in very low birth weight infants (<1,500 g). However, breast milk may not be sufficient to meet these needs. The possibility of supplementing breast milk with a lyophilisate of human milk was explored in this study. The objectives of this study were to determine the total lipid content and the lipid profile of the Human Milk on Baseline (HMB) and that of the Concentrates with the Human Milk + lyophilisate (with lyophilisate of milk in the immediate period (HMCI), at 3 months (HMC3m), and at 6 months (HMC6m) of storage).MethodsFifty donors from the Human Milk Bank of Children’s Hospital provided consent, and donated milk samples. Macronutrient (including total lipids) quantification was performed using the MIRIS® Human Milk Analyzer, and the fatty acid profile was determined by gas chromatography (CG-FID, SHIMADZU®).ResultsThere was a higher lipid concentration in HMCI relative to HMB. The concentrations of the main fatty acids (% of total) were as follows: palmitic acid (C16:0) HMB, 22.30%; HMCI, 21.46%; HMC3m, 21.54%; and HMC6m, 21.95% (p<0.01); oleic acid (C18:1n-9) HMB, 30.41%; HMCI, 30.47%; HMC3m, 30.55%; and HMC6m, 29.79% (p = 0.46); linoleic acid (C18:2n-6) HMB, 19.62%; HMCI, 19.88%; HMC3m, 19.49%; and HMC6m, 19.45% (p = 0.58); arachidonic acid (C20:4n-6) HMB, 0.35%; HMCI, 0.16%; HMC3m, 0.13%; and HMC6m, 0.15% (p<0.01); α-linolenic acid (C18:3n-3) HMB,1.32%; HMCI, 1.37%; HMC3m, 1.34%; and 1.34% HMC6m (p = 0.14); docosahexaenoic acid (C22:6n-3) HMB, 0.10%; HMCI, 0.06%; HMC3m, 0.05%; and HMC6m, 0.06% (p<0.01). There were no significant changes in the lipid profile when stored. There was no evidence of peroxidation during storage.ConclusionsFreeze-dried human milk fortified with a human milk concentrate brings potential benefits to newborns, mainly by preserving the essential nutrients present only in breast milk; however, further clinical studies are required to evaluate the safety and efficacy of the concentrate as a standard nutritional food option for very low birth weight infants.

Combination of High-Pressure Processing and Freeze-Drying as the Most Effective Techniques in Maintaining Biological Values and Microbiological Safety of Donor Milk

“…Apart from the findings by Salcedo et al (2015) on the successful reduction of germs in breast-milk after freeze-drying, it was shown that storage of freeze-dried milk did not show a significant influence upon several biological properties of human milk such as total antioxidant capacity and fatty acid profile of milk [ 21 , 22 , 23 , 24 ]. The storage and transport of milk powder is also considerably less complicated in the hospital setting and makes possible longer storage than in the case of pasteurized milk, which must be frozen [ 21 , 22 , 25 ].…”

“…Furthermore, the powder can be easy to reconstitute at a given volume to obtain the required caloric and nutrition value of milk for preterm infants [ 25 , 26 ].…”

Maternal Nutrition Status and Human Milk Composition of DHA and AA Fatty Acids in Breastfeeding Honduran Women

“…Honduras has extensive coastlines in the Atlantic and Pacific oceans, but fish consumption (which is not from sea origin) is very low, as shown in the results of the study. The AA content in BM is usually stable [3], fluctuating slightly around 0.5% of total fatty acids as it is mostly derived from maternal reserves [29]; however, the DHA concentration is much more variable, constituting 0.1% to 1.0% of total fatty acids [5]. To maintain an adequate concentration of AA and DHA, it is recommended that at least 200 mg/day of preformed DHA be consumed daily [2,57], however, consumption in our sample was found to be well below the recommendation (40 mg/day).…”

“…Breastfeeding (BF) from healthy, well-nourished mothers is the ideal food to meet the nutritional demands of full-term babies [1][2][3][4] promoting their growth and the development of their gastrointestinal [5,6], immunological [7] and neurological [8] systems, owing to its unique content of essential nutrients [9,10], hormones, antibodies and biologically-active molecules [11,12]. The World Health Organization (WHO) recommends exclusive BF (EBF) for the first six months of life and continuing it in conjunction with feeding for two years or more [13,4].…”

“…Numerous studies have shown that frequent consumption of seafood such as fatty fish and shellfish improves the concentration of EFA and particularly the concentration of DHA [29,34] despite the fact that there is a disparity in access to these foods conditioned by physical accessibility and socioeconomic status [35]. In addition, the increase in the consumption of highly processed foods [21,36,37] made from refined oils [5,27], have displaced the consumption of healthy meats, fish and fats [21], causing an imbalance in the ratio of omega-3 and omega-6 fatty acids in breast milk [5,22].…”