Abstract
A primary role of Human Milk Banks (HMBs) is to provide human milk (HM) for preterm infants and to support the mothers of these infants as they establish their own milk supply. A better understanding of the variation in the energy and macronutrients contents of donor human milk (DHM) potentiates targeted nutrition for preterm babies. Therefore, the aim of this study was to assess the variability of energy and macronutrients content in DHM and to investigate the impact of maternal factors and feeding practices on the nutritional value of DHM. The study involved 49 donors registered in the HMB in the Holy Family Hospital in Warsaw, Poland. Samples from each donor were pooled within a maximum of two weeks. The composition of DHM, including energy content, protein, fat, and carbohydrate concentrations, was analyzed using the Miris Human Milk Analyzer. The analyses were performed before the pasteurization process. The mean time of milk donation to HMB was 13.2 ± 6.0 weeks. There were no significant differences in energy and macronutrients contents of DHM in the beginning and at the end of milk donation to HMB, however, HM fat concentration was positively correlated with afternoon feedings (r = 0.289, p = 0.044). The method of feeding (breastfeeding vs. feeding only expressed milk) also did not impact the nutritional value of DHM. Future research for the DHM should include a further cross-sectional observational study with the collection of detailed donor information and characteristics of milk expression and feeding practices to further evaluate the pooling processes and the effect on DHM composition.
Highlights
World Health Organization [1], American Academy of Pediatrics [2], European Society for Pediatric Gastroenterology, Hepatology and Nutrition [3] and Polish Experts Group [4]recommend donor human milk (DHM) as the preferred feeding strategy for preterm infants when the milk of the mother is unavailable
Recommend donor human milk (DHM) as the preferred feeding strategy for preterm infants when the milk of the mother is unavailable. This recommendation is based on conclusive evidence of lower rates of necrotizing enterocolitis (NEC) with the use of DHM feeding compared with preterm infant formulas [1,2,3]
We have shown that the expression pattern of milk donated to Human Milk Banks (HMBs) may influence HM fat concentration
Summary
Recommend donor human milk (DHM) as the preferred feeding strategy for preterm infants when the milk of the mother is unavailable. This recommendation is based on conclusive evidence of lower rates of necrotizing enterocolitis (NEC) with the use of DHM feeding compared with preterm infant formulas [1,2,3]. DHM may be associated with improved feeding tolerance (compared with formula) and with reduced cardiovascular risk factors during adolescence [3]. In the NICU, DHM acts as a bridge until mother’s own milk (MOM) productions meet the infant’s requirements and result in an increased MOM production. In a multicenter study [6], the use of DHM was associated with 10% increase in the rate of MOM utilization and 2.6% decrease in the rate of NEC
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