Abstract
BackgroundAccurately targeting the nutritional needs of the early preterm infant is challenging when human milk is used due to the natural variation in energy composition. The purpose of this study was to develop and evaluate a simple method for reducing the variation in fat and energy content of human milk prior to fortification such that the infant receives a diet of known composition.MethodsMilk was centrifuged at low speed to concentrate the fat into a cream layer and a predetermined volume of skim milk is removed to meet a specific fat concentration. The fat layer is then resuspended to produce reconstituted milk of a specified standard fat content.ResultsUsing this method it was possible to reduce the coefficient of variation in fat content of six different samples of donor human milk from 19.3% to 2.6%. As fat globule size may be associated with fat absorption, the effect that centrifugation and resuspension had on human milk fat globule distribution was assessed by laser diffraction particle sizing. No difference in the particle distribution of the treated and untreated human milk was observed.ConclusionThis method is accurate and simple, allowing for integration alongside current milk bank and NICU practices for use with both donor human milk and mother's own milk.
Highlights
Targeting the nutritional needs of the early preterm infant is challenging when human milk is used due to the natural variation in energy composition
Current recommendations of reasonable nutrient intakes state that protein:energy ratios of between 2.5–3.4 g protein/100 kcal of energy are required for extremely low birth weight (ELBW) infants and 2.6–3.8 g protein/ 100 kcal for very low birth weight (VLBW) infants [7]
Optimal relative centrifugal force for readily resuspending the cream layer To allow the volume of skim milk to be adjusted to meet the specified total fat content, human milk was centrifuged to collect the cream in a layer at the top of the milk
Summary
Targeting the nutritional needs of the early preterm infant is challenging when human milk is used due to the natural variation in energy composition. The purpose of this study was to develop and evaluate a simple method for reducing the variation in fat and energy content of human milk prior to fortification such that the infant receives a diet of known composition. Human milk is not adequate to meet the nutritional needs of the early premature infant [5] and it is common practice to fortify the human milk prior to enteral feeding [6]. Fortification provides essential vitamins and minerals at necessary levels not ordinarily found in human milk, and is especially required to meet the protein and energy needs vital for adequate growth. Given that the energy content of human milk (page number not for citation purposes)
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