Term Infants Fed Exclusively With Donor Milk May Require Vitamin C Supplementation

Abstract

Background: When there is insufficient mother's milk for preterm infants, fortified human donor milk (DM) is the preferred supplement. Recently, there is growing interest in providing DM to term infants. Aside from vitamin D, mother's milk is a complete source of nutrition for term infants. It is unknown whether supplementation of micronutrients is required for term infants exclusively fed DM, particularly for nutrients affected by heat processing, such as vitamin C. The objective of this study was to determine the total vitamin C content in DM and whether it would be adequate for an infant exclusively fed DM. Methods: DM samples (n = 56) were collected at a Canadian milk bank from April to August 2018. Vitamin C concentration was determined by high-performance liquid chromatography. Results: DM samples had a vitamin C concentration of 17.7 ± 9.8 mg/L (mean ± SD) and were variable, ranging from 1.9 to 43.2 mg/L. Using these values and assuming an exclusive DM consumption of 780 mL/day, the estimated vitamin C intake would be 13.8 ± 8.6 mg (mean ± SD), falling below the adequate intake of 40 mg/day for infants (0-6 months old). Conclusion: Vitamin C supplementation is required for all infants if DM is the sole source of nutrition. Future studies should investigate other heat-and light-sensitive nutrients.

Global neonatal care and access to human milk

“…While there is limited information on the cost of producing donor human milk, several factors may be influenced by the scale of production including cost, access, product standards, and the capacity to provide additional services. Recent studies suggest that donor human milk may be highly variable in some micronutrients including vitamin C and sodium, 15 , 16 and well below current nutrient recommendations, suggesting that product standards for donor human milk may improve nutritional support. In terms of access, rBHL reports that almost 240,000 infants received donor human milk in 2021.…”