Human milk macronutrient analysis using point-of-care near-infrared spectrophotometry

Sauer, Charles W.; Kim, J H

doi:10.1038/jp.2010.123

Cited by 48 publications

(25 citation statements)

References 30 publications

(38 reference statements)

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“…9,10 However, in the case of preterm infants, differences in the constituents of human milk vary greatly depending on maternal age, nutrition and period of lactation. 11 Therefore, human milk does not always meet the preterm infant's increased nutrient and protein demand. 12 Standard fortification of human milk has shown to increase growth in preterm infants, 13 and newer methods of fortification such as individualized (targeted to actual human milk content) and adjustable (human milk content changed on the basis of infant serum lab values) fortification are proving to be beneficial.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of human milk fortification from the time of the first feeding: effects on infants of less than 31 weeks gestational age

2011

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Objective: To determine whether human milk fortification from the time of the first feeding significantly improves weight gain and bone mineral status in infants of <31 weeks estimated gestational age as compared with delayed or standard human milk fortification.Study Design: This was a retrospective pre-post design. In all, 95 infants born at <31 weeks estimated gestational age were compared. There were 53 infants in the early fortification group (EFG) and 42 infants in the delayed fortification group (DFG). They were compared with regard to weight gain at 34 weeks postmenstrual age (PMA), and their serum levels of calcium, phosphorus and alkaline phosphatase levels were compared as an indicator of bone mineral status. The practice change of fortifying all human milk given to preterm infants at <34 weeks PMA commenced in June 2009. The usual practice of fortification took place once an infant had reached a feeding volume of 50 to 100 ml kg À1 per day. The new practice fortified all human milk with a powdered human milk fortifier to 24 calories per ounce, starting with the first feeding, no matter how small the volume.Result: There were no differences in weight gain between the EFG and the DFG. The group that received fortification from the time of the first feeding were significantly less likely to have alkaline phosphatase levels >500 U l À1 from 33 weeks PMA onward. There was no incidence of feeding intolerance with early fortification.Conclusion: Fortification of human milk from the time of the first feeding does not affect weight gain at 34 weeks PMA, but is related to a lower incidence of elevated alkaline phosphate levels and does not cause feeding intolerance.

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Section: Introductionmentioning

confidence: 99%

Evaluation of human milk fortification from the time of the first feeding: effects on infants of less than 31 weeks gestational age

2011

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“…Common practice is to fortify on an assumed average preterm breast milk composition (6,7,9) ; however, significant variation in the macronutrient content of breast milk exists between and within mothers (6,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) , reflected by wide variations in macronutrient values derived by studies and adopted by neonatal intensive care units and industry to fortify milk, raising concerns that this practice may lead to undernourishment of some infants and over-nourishment of others (7) . The lack of a globally accepted reference 'assumed' preterm breast milk composition inhibits standardised reporting of nutritional intakes, making it difficult for clinicians and researchers to assess the adequacy of nutritional intakes and the role of nutrition in growth and developmental preterm outcomes.…”

mentioning

confidence: 99%

Preterm human milk composition: a systematic literature review

et al. 2016

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There are wide variations in the macronutrient values adopted by neonatal intensive care units and industry to fortify milk in efforts to achieve recommended intakes for preterm infants. Contributing to this is the variation in macronutrient composition of preterm milk between and within mothers and the variable quality of milk analyses used to determine the macronutrient content of milk. We conducted a systematic review of the literature using articles published in English between 1959 and 2013 that reported the concentrations of one or more macronutrients or energy content in human preterm milk, sampled over a representative 24-h period. Searched medical databases included Ovid Medline, Scopus, CINAHL and the Cochrane Library. Results are presented as mean values and ranges for each macronutrient during weeks 1-8 of lactation, and preferred mean values (g/100 ml) for colostrum (week 1) and mature milk (weeks 2-8; protein: 1·27, fat: 3·46, lactose: 6·15 and carbohydrate: 7·34), using data from studies employing the highest-quality analyses. Industry-directed fortification practices using these mean values fail to meet protein targets for infants weighing <1000 g when the fortified milk is fed <170-190 ml/kg per d, and the protein:energy ratio of the fortified milk is inadequate. This study aimed to provide additional information to industry in order to guide their future formulation of breast milk fortifiers. Quality macronutrient analyses of adequately sampled preterm breast milk would improve our understanding of the level of fortification needed to meet recommended protein and energy intakes and growth targets, as well as support standardised reporting of nutritional outcomes.

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“…There are no good determinants of this variability with well nourished mothers [23]. For example, in the first month of lactation, there is a loss of approximately 25% in total protein in the first month with a more gradual decline thereafter even out to six months of lactation [24].…”

Section: Properties Of Hmmentioning

confidence: 99%

“…These include creamatocrit, mid-infrared and near infrared spectrophotometry [23,27,28]. Alternative strategies without the use of milk analysis include adjustable fortification approaches using the blood urea nitrogen to determine appropriate protein intake [29].…”

Section: Measuring Nutrient Content In Hmmentioning

confidence: 99%

Challenges in the practice of human milk nutrition in the neonatal intensive care unit

Kim¹,

Chan²,

Vaucher³

et al. 2013

Early Human Development

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Human milk macronutrient analysis using point-of-care near-infrared spectrophotometry

Cited by 48 publications

References 30 publications

Evaluation of human milk fortification from the time of the first feeding: effects on infants of less than 31 weeks gestational age

Evaluation of human milk fortification from the time of the first feeding: effects on infants of less than 31 weeks gestational age

Preterm human milk composition: a systematic literature review

Challenges in the practice of human milk nutrition in the neonatal intensive care unit

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