Docosahexaenoic Acid (DHA) and Amino Acids (AA) are limiting in Pasteurized Donor Milk from a Cross Sectional Sampling in The North American Milk Banks

Abstract

BackgroundDHA and AA are important nutrients for the growing infant and have been previously shown to be limiting in a Midwestern donor bank. With the increased use of donor milk nationally, it is imperative to understand if these low values are consistent across the United States (U.S.).ObjectivesWe tested the hypotheses that the DHA and AA would be lower nationally in donor milk for the high risk infant.MethodsA prospective sampling of milk from 6 milk banks in North America‐ (New England [NE], Ohio, Michigan, Colorado, Ft Worth, Texas, and California) were collected after informed consent and IRB approval. 15‐ 16 milk samples with lactational stage 1–5.5 months were obtained from each milk bank (except NE, n=6). The samples were pooled to minimize variability. DHA was measured by GC; AA were measured by HPLC. Kruskal‐ Wallis with Dunn's Multiple Comparison was used in analysis.ResultsThe DHA content did not differ significantly across banks (median value of 29–39 mg/100 ml), but overall, provided an intake lower than the fetal accretion value for the high risk neonate. AA did not differ except for isoleucine and leucine which were significantly higher in NE (p=0.03)ConclusionNationally, donor milk is low in DHA and variable for isoleucine and leucine. Since the primary target for donor human milk is the high risk neonate, this survey should prompt nutrient supplementation strategies.