Implementation of the Use of Skimmed Breast Milk and the Registered Dietitian Nutritionist’s Role

Clark, Brittani; Froh, Melissa; Polzin, Elizabeth

doi:10.1016/j.jand.2018.03.020

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…A study of 12 children with NS who were randomly assigned to gemfibrozil or placebo showed serum cholesterol, LDL, and serum triglyceride concentrations lowering with gemfibrozil treatment. 10 However, these results have not been evaluated in CNS.…”

Section: Discussionmentioning

confidence: 99%

Skimmed breast milk for treatment of hypertriglyceridemia in an infant with congenital nephrotic syndrome

et al. 2021

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Congenital nephrotic syndrome (CNS) is a complex condition that requires multidisciplinary care. Hyperlipidemia is a characteristic feature with elevation of serum cholesterol and triglycerides. Little evidence is available to guide treatment of dyslipidemia in infants with CNS. We describe successful treatment of severe hypertriglyceridemia through dietary changes in a boy with CNS. A 9-day-old boy presented to the emergency department with lower extremity edema caused by deep venous thrombosis. Laboratory evaluation identified hypoalbuminemia, nephrotic-range proteinuria, and a pathogenic variant of the NPHS1 gene. The initial triglyceride concentration of 369 mg/dl increased to 3096 mg/dl by 5 weeks of age, when his diet consisted of breast milk. Refrigerated breast milk was skimmed by removing the top layer after allowing it to separate for 24 h. This process was repeated prior to use. Skimmed breast milk was supplemented with medium-chain triglyceride oil and an infant protein powder. After 2 days, the triglyceride concentration declined to 481 mg/dl and, by day 10, to 148 mg/dl. When breast milk supply decreased, a 1:1 ratio of skimmed maternal breast milk to an elemental, very low-fat formula was utilized. The triglyceride concentration remained below 400 mg/dl for the first year of life, except when skimmed breast milk was not available during hospitalization. Severe hypertriglyceridemia caused by CNS can present in the neonatal period and be difficult to manage. In our patient, skimmed maternal breast milk was successful in reducing the triglyceride concentration and should be considered a therapeutic option for children with hyperlipidemia caused by CNS.

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Section: Discussionmentioning

confidence: 99%

Skimmed breast milk for treatment of hypertriglyceridemia in an infant with congenital nephrotic syndrome

et al. 2021

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“…The steps taken to implement SHM have been previously described. 9 Enfamil Enfaport 10 formula was the standard high-MCT infant formula used at the research hospital during the study period and standardly comes as a liquid formula of 30 calories per ounce. Fortification using a liquid vs a powder is preferred in the intensive care units for safety (to decrease risk of infection).…”

Section: Design and Methodsmentioning

confidence: 99%

“…Mother's own human milk was skimmed using an Eppendorf Centrifuge 5702R in the Human Milk Kitchen by milk technicians per hospital protocol, which has been explained in detail previously. 9 Briefly, a centrifuge was used to separate the fat in the milk and a stylet pulled the milk away from the fat. A crematocrit was used to determine caloric density of SHM prior to fortification.…”

Section: Design and Methodsmentioning

confidence: 99%

“…Term or corrected‐to‐term infants aged ≥37 weeks' gestation who required a high‐MCT/low‐LCT diet with no known food allergies were recruited for the study from inpatient units that were serviced by the hospital milk kitchen. The steps taken to implement SHM have been previously described 9 . Enfamil Enfaport 10 formula was the standard high‐MCT infant formula used at the research hospital during the study period and standardly comes as a liquid formula of 30 calories per ounce.…”

Section: Design and Methodsmentioning

confidence: 99%

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Assessing growth of infants with chylothorax receiving fortified skimmed human breast milk

et al. 2022

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Learning Outcome: To learn how skimmed human milk (SHM) can be used in infants with chylothorax to support adequate weight gain and nutrition while receiving human milk.Background: Traditional nutrition management for chylothorax is to limit longchain triglycerides (LCTs) and provide a diet high in medium-chain triglycerides (MCTs). Transition from human milk to formula has been required to provide the ratio of MCT to LCT required to stop the accumulation of chyle. Although SHM may provide the right fat content for a baby with chylothorax, previous studies have shown slow growth in infants receiving SHM.Objective: To demonstrate that infants receiving SHM fortified with high-MCT infant formula will have age appropriate growth without re-accumulation of chyle. Design/Methods: Between 2017 and 2019, term infants with the diagnosis of chylothorax who were previously receiving human milk and transitioned to fortified SHM were monitored for growth and reaccumulation of chyle. Results:The six infants who were prescribed fortified SHM with high-MCT infant formula using standardized recipes did not show reaccumulation of chyle and showed positive weight gain in five of the six study patients. The infants gained a mean weight of 30.5 g/day (±19.5), and their weight z scores improved by a mean of +0.29 (±0.33).Conclusions: Fortified SHM is a safe treatment option that can provide adequate nutrition for the infant with chylothorax to gain weight appropriately for age.

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Selenium in selected samples of infant formulas and milk commercialized in Belgium and Brazil: Total content, speciation and estimated intake

Paiva

Ruttens

Waegeneers

et al. 2023

Food Research International

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Implementation of the Use of Skimmed Breast Milk and the Registered Dietitian Nutritionist’s Role

Cited by 5 publications

References 7 publications

Skimmed breast milk for treatment of hypertriglyceridemia in an infant with congenital nephrotic syndrome

Skimmed breast milk for treatment of hypertriglyceridemia in an infant with congenital nephrotic syndrome

Assessing growth of infants with chylothorax receiving fortified skimmed human breast milk

Selenium in selected samples of infant formulas and milk commercialized in Belgium and Brazil: Total content, speciation and estimated intake

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