Human Milk Analyzer Research Articles

A human β-casein-derived peptide BCCY-1 modulates the innate immune response

In this study, we report a novel peptide corresponding to the sequence of human β-casein (named BCCY-1), which was identified in our previous peptidome analysis of human milk and has great immunomodulatory activity. The results revealed that peptide BCCY-1, but not the scrambled version, enhanced monocyte migration without obvious toxicities. This selective effect was mediated via increased production of chemokines by peptide stimulated monocytes. Moreover, BCCY-1 exerted its modulatory effects by activating nuclear factor (NF)-κB and mitogen-activated protein kinase (MAPK) signaling. The abundances of peptide BCCY-1 and the peptides partially encompassing its fragment were found to be lower in preterm milk than in term milk. Our study may lead to new insights into the immunoregulatory effects of casein-derived peptides and facilitate the discovery of novel peptide-based food and pharmaceutical products.

Changes in macronutrients of human milk after bolus feeding: a simulation study.

Enteral nutrition supply to preterm infants requires feeding through a feeding tube. The aim of this study was to evaluate changes in macronutrient composition of human milk (HM) while passing through a gastric feeding tube. Simulated real-life practice tube feeding was performed by using an infusion pump connected to a feeding tube. A human milk analyzer was used to compare the pre infusion and post infusion macronutrient contents of HM. There was a significant decrease in fat (from 4.06 ± 0.6 g/100 ml to 3.95 ± 0.6 g/100 ml), carbohydrates (from 7.51 ± 0.4 g/100 ml to 7.33 ± 0.5 g/100 ml), and energy content (from 70.77 ± 5.4 kcal/100 ml to 69.72 ± 0.5 kcal/100 ml) after passing through the feeding tube (P < 0.001). A simulated real-life bolus tube feeding model demonstrated small but significant decreases in fat, carbohydrate, and energy content. The biological significance of our results to the very low birth weight infants should be further studied.

Customized Human Milk Fortification Based on Measured Human Milk Composition to Improve the Quality of Growth in Very Preterm Infants: A Mixed-Cohort Study Protocol.

Adequate nutrition of very preterm infants comprises fortification of human milk (HM), which helps to improve their nutrition and health. Standard HM fortification involves a fixed dose of a multi-nutrient HM fortifier, regardless of the composition of HM. This fortification method requires regular measurements of HM composition and has been suggested to be a more accurate fortification method. This observational study protocol is designed to assess whether the target HM fortification method (contemporary cohort) improves the energy and macronutrient intakes and the quality of growth of very preterm infants, compared with the previously used standard HM fortification (historical cohorts). In the contemporary cohort, a HM multi-nutrient fortifier and modular supplements of protein and fat are used for HM fortification, and the enteral nutrition recommendations of the European Society for Paediatric Gastroenterology Hepatology and Nutrition for preterm infants will be considered. For both cohorts, the composition of HM is assessed using the Miris Human Milk analyzer (Uppsala, Sweden). The quality of growth will be assessed by in-hospital weight, length, and head circumference growth velocities and a single measurement of adiposity (fat mass percentage and fat mass index) performed just after discharge, using the air displacement plethysmography method (Pea Pod, Cosmed, Italy). ClinicalTrials.gov registration number: NCT04400396.

Preterm infant nutrition and growth with a human milk diet

Human milk is the preferred enteral diet for preterm infants. It provides macronutrients, micronutrients, and bioactive factors that support physical growth and neurodevelopment. Challenges of the human milk diet include the variability in its composition and a need for fortification to mirror placental nutrient delivery and prevent extrauterine growth restriction. Various strategies exist to attain target nutrient provision and optimize growth, including leveraging new technology for point-of-care human milk analysis. When maternal milk is unavailable or in short supply, pasteurized donor human milk is the preferred alternative. Infants fed donor milk may have slower weight gain than those fed exclusively maternal milk or formula, whereas infants fed fortified maternal milk have similar weight gain to preterm formula-fed infants. Future directions include more rigorous characterization of the variation in human milk, further investigation of the clinical benefits of non-nutrient bioactive factors in milk, and novel approaches to optimize fortification.

Longitudinal human milk macronutrients, body composition and infant appetite during early life

Breastfeeding is the gold standard infant feeding. Data on macronutrients in relation to longitudinal body composition and appetite are very scarce. The aim of this study was to investigate longitudinal human milk macronutrients at 1 and 3 months in association with body composition and appetite during early life in healthy, term-born infants. We hypothesized that infants receiving higher caloric human milk would have more body fat mass and satiate earlier. In 133 exclusively breastfed infants (Sophia Pluto Cohort), human milk samples at 1 and 3 months were analyzed for macronutrients (fat, protein, carbohydrate) by MIRIS Human Milk Analyzer, with appetite assessment by Baby Eating Behavior Questionnaires. Fat mass (FM) and fat-free mass (FFM)were measured by PEA POD and DXA, and abdominal FM by ultrasound. Milk samples showed large differences in macronutrients, particularly in fat content. Protein and energy content decreased significantly from 1 to 3 months. Fat and carbohydrate content tended to decrease (p=0.066 and 0.081). Fat (g/100ml) and energy (kcal/100ml) content at 3 months were associated with FM% at 6 months (β 0.387 and 0.040, resp.) and gain in FM% from 1 to 6 months (β 0.088 and 0.009, resp.), but not with FM% at 2 years. Carbohydrate content at 3 months tended to associate with visceral FM at 2 years (β 0.290, p=0.06). Infants receiving higher caloric milk were earlier satiated and finished feeding faster. Our longitudinal data show decreasing milk protein and energy content from age 1 to 3 months, while fat and carbohydrate tended to decrease. Macronutrient composition, particularly fat content, differed considerably between mothers. Milk fat and energy content at 3 months associated with gain in FM% from age 1 to 6 months, indicating that higher fat and energy content associate with higher gain in FM% during the critical window for adiposity programming. As infants receiving higher caloric breastfeeding were earlier satiated, this self-regulatory mechanism might prevent intake of excessive macronutrients. NTR, NL7833.

Significant Loss of Macronutrients During Passage Through Feeding Tube: An Observational Study.

Eleven frequently used formulas were chosen. Ten consecutive measurements were performed for each formula. Simulated real-life practice tube feeding was performed by using an infusion pump connected to a feeding tube. A Human Milk Analyzer, using an infrared spectroscopy method, was used to compare the preinfusion and postinfusion macronutrient contents of the different formulas. A total of 220 measurements were performed. Variations in at least one macronutrient were observed in 5 out of 10 formulas. Fat and energy content were modified in 1 preterm formula. Changes in the macronutrient content after tube feeding transfer were observed for some infant formulas, including those designed for very low birth weight infants. These alterations might relate to specific formulation of each formula. The biological significance of our results to the very low birth weight infants should be studied further.

Macronutrient Composition of Donated Human Milk in a New Zealand Population.

A primary role of human donor milk banks is to provide pasteurized human milk for the sick and preterm infant populations and to support the mothers of these infants as they establish their own milk supply. The results of human milk pasteurization continue to be studied to provide information that enables optimal nutrition in this sick and preterm population. The aims of our study were to determine macronutrient characteristics (fat, protein, carbohydrate) and energy content of human milk donated to the Christchurch Women's Hospital Human Milk Bank in New Zealand, and the influence of Holder pasteurization on this macronutrient composition. This was a retrospective, pre/post pasteurization observational design to describe the macronutrient content within two groups of donors, mature preterm PDM (n = 13; 21%) and mature term PDM (n = 50; 79%). Sixty three samples of human milk donated to the human milk bank by 27 registered participants (mothers of preterm and term infants) were analyzed. This analysis took place July-September 2018 using a human milk analyzer before and after Holder pasteurization (62.5 °C for 30 min). Preterm milk contained on average 76 kcal/100 ml energy, 4.0 g/100 ml fat, 1.1 g/100 ml protein and 8.2 g/100 ml total carbohydrate; and mature term milk contained 68 kcal/100 ml energy, 3.5 g/100 ml fat, 0.8 g/100 ml protein and 7.9 g/100 ml total carbohydrate. Wide variation between single, donor-pooled samples was demonstrated and there was no major result of pasteurization. This research adds to the evidence regarding the macronutrient content of preterm and term milk and that these values are unaffected by Holder pasteurization. The variance in individual pooled donor human milk indicates the importance of determining the nutrient composition of donated milk to inform fortification procedures.

Infrared analyzers for the measurement of breastmilk macronutrient content in the clinical setting

ABSTRACT Introduction There is growing interest in the possibility of measuring the macronutrient content of human milk. Several studies that intend to validate commercially available human milk analyzers have been published with inconsistent results. This review will focus on currently available, verified methodologies for analyzing macronutrients in human milk. Areas covered A literature search was conducted in the PubMed database. Five milk analyzers were chosen to be included in this review: MIRIS (Uppsala, Sweden) (seven articles found), Calais (Cleveland, United States) (four articles), SpectraStar (Brookfield, United States) (four articles), MilkoScan (Hillerdo, Denmark) (two articles), and Delta LactoScope (Stockholm, Sweden) (one article). The following information was extracted from published manuscripts: measuring device, sample preparation, purpose of the study, type of macronutrients studied, results, and conclusions. Expert opinion Infrared spectroscopy can be an accurate and reliable technology for assessing the macronutrient content of human milk, specifically crude protein, and total fat. However, an optimal handling of samples, the development of standardized quality-control protocols, and an improvement in calibration procedures are required before the full implementation of infrared technology in neonatal units.

Impact of Infant and Maternal Factors on Energy and Macronutrient Composition of Human Milk.

The present study investigates the influence of selected infant and maternal factors on the energy and macronutrient composition of mature human milk (HM). The study enrolled 77 mothers at 4–8 weeks postpartum. Each mother provided 1 sample of HM. Each extracted HM sample was formed by mixing four subsamples of HM, each of which were obtained in one predefined 6-h periods of the day. Among maternal factors, the analysis included: anthropometric data before and after pregnancy; weight gain in pregnancy; body composition, assessed using the Maltron BioScan 920-II to analyze bioimpedance; and dietary intake, assessed with three-day dietary records. Among the neonatal factors, birth weight and length, number of daily feedings and type of delivery were included. The composition of HM, including energy content, protein, fat and carbohydrate concentrations, was analyzed using the Miris human milk analyzer. Pearson’s and Spearman’s correlation coefficients and multivariable logistic regression models were used to analyze the association between the selected maternal and infant factors and HM milk composition. It was found that total protein content of HM was correlated with pre-pregnancy BMI (Spearman rho = 0.238; p = 0.037), current lean body mass (Spearman rho = −0.293, p = 0.01) and total water content (Spearman rho = −0.315, p = 0.005). Carbohydrates were the only macronutrients whose composition was significantly affected by the infant factors. It was reported that higher carbohydrate content was associated with male sex (OR = 4.52, p = 0.049). Our results show that maternal and infant factors, especially maternal pre-pregnancy and current nutritional status and infant sex, interact and affect HM composition, suggesting that macronutrient and energy content in HM may be determined in pregnancy and may have unique compositional profile for every mother–infant dyad.

A Systematic Review of Collection and Analysis of Human Milk for Macronutrient Composition

As human milk (HM) composition varies by time and across even a single feed, methods of sample collection can significantly affect the results of compositional analyses and complicate comparisons between studies. The aim was to compare the results obtained for HM macronutrient composition between studies utilizing different sampling methodologies. The results will be used as a basis to identify the most reliable HM sampling approach. EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, and ProQuest databases were searched for relevant articles. Observational and interventional studies were included, and at least 2 authors screened studies and undertook data extraction. Quality assessment was conducted using the Newcastle-Ottawa scale and previously published pragmatic score. A total of 5301 publications were identified from our search, of which 101 studies were included (n=5049 breastfeeding women). Methods used for HM collection were divided into 3 categories: collection of milk from all feeds over 24h (32 studies, n=1309 participants), collection at one time point (62 studies, n=3432 participants), and "other methods" (7 studies, n=308 participants). Fat and protein concentrations varied between collection methods within lactation stage, but there were no obvious differences in lactose concentrations. There was substantial variability between studies in other factors potentially impacting HM composition, including stage of lactation, gestational age, and analytical method, which complicated direct comparison of methods. This review describes the first systematic evaluation of sampling methodologies used in studies reporting HM composition and highlights the wide range of collection methods applied in the field. This information provides an important basis for developing recommendations for best practices for HM collection for compositional analysis, which will ultimately allow combination of information from different studies and thus strengthen the body of evidence relating to contemporary HM composition. This trial was registered at PROSPERO as CRD42017072563, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017072563.

Supported ionic liquid adsorbent and ELSD–HPLC method as an alternative procedure for exogenous fatty acid analysis in breast milk

This article proposes a new method for sample preparation via synthesis of a sorbent based on silica gel functionalized with ionic liquid. Ionic liquids (ILs) have a great potential for application in extraction techniques as they can interact by hydrophobic and π–π interaction. Thus ionic liquid-modified silica [SiO2-MIM-BF4−] adsorbent was proposed for isolation of fatty acids such as docosahexaenoic, eicosapentaenoic and arachidonic acid. The main goal and novelty of this research was the application of the developed adsorbent to human milk analysis. In an application study, the synthesized adsorbent was used in dispersive solid phase extraction in combination with liquid chromatography coupled with evaporative light scattering detector. The linear range for the ELSD concentration response was wider (135–1626 µg/mL) for polyunsaturated fatty acid methyl esters. The recovery study demonstrated recovery between 67% and 78% for specific acids with relative standard deviation lower than 6%.

A Cross Sectional Study on Analysis of Human milk as per Prakriti (Psychosomatic Constitution).

A Cross Sectional Study on Analysis of Human milk as per Prakriti (Psychosomatic Constitution).

The Effect of Physical Activity on Human Milk Macronutrient Content and Its Volume.

Objective: There are multiple health benefits associated with both breastfeeding and practicing physical activity (PA). Therefore, it is likely that many women might want to engage in both. We designed the current randomized clinical trial to examine the effect of moderate- to high-intensity PA on human milk (HM) volume and macronutrient contents. Methods and Study Design: In this prospective, randomized, crossover clinical trial, we recruited 31 healthy mothers who had been exclusively breastfeeding their infants. Mothers expressed HM twice each day on 2 consecutive days-a day with PA (1-hour before and 1-hour after PA) and a control day without PA (at the exact same hours of the day). The order of days (with/without PA) was determined randomly. Macronutrients and energy contents of HM were analyzed using the Human Milk Analyzer (Miris AB, Uppsala, Sweden). PA was graded according to the Borg Rating of Perceived Exertion scale (RPE scale). Results: A total 124 HM samples from 31 mothers were analyzed. Moderate- to high-intensity PA affected neither macronutrients (fat, carbohydrates, protein) nor energy content. Milk volume remained unaffected by PA as well. Conclusions: Maternal PA does not affect HM volume or its macronutrient contents. Lactating mothers can be reassured regarding their breast milk volume and composition while practicing PA of moderate to high intensity.

Satisfaction of mothers regarding human milk donation

In France, human milk banks are in charge of the collection, analysis, processing, and distribution of human milk to neonatology centers for preterm infants. Knowledge of what motivates mothers to donate their milk could lead to better communication regarding human milk donation. A satisfaction survey was conducted among mothers who were donating their milk to a human milk bank. In total, 214 mothers answered a questionnaire in the presence of the collector during a home visit. The median age of the mothers was 31 years (18–46), mainly high school (19%) or university (65%) graduates, and the median duration of donation was 3 months (0.5–22). At the time of the study, the median age of infants was 3 months (0.5–25), and 88% of infants were exclusively breastfed. About three quarters of mothers were motivated by willingness to help others, a quarter of them being especially sensitive to premature neonatal care; 30% of mothers were motivated by having a high supply of milk. Around 25% of mothers were given information on human milk donation during pregnancy, and two thirds after delivery, mainly by the maternity ward midwives (53.4%) or by collectors during their visit (14.1%). Most mothers (72%) found the human milk donation process easy and most of them (92.5%) were willing to donate their milk again after their next pregnancy. This survey shows that more than 90% of mothers are satisfied with donation to human milk banks. However, efforts should be made to provide information on breastfeeding and human milk donation to the general population and health professionals.

Macronutrient analysis of donor human milk labelled as 24 kcal/oz.

To measure the macronutrient content (MNC) of donor human milk labelled as 24 kcal/oz ("high-calorie DHM," hcDHM), compare to bank-labelled MNC, and examine variability of hcDHM MNC among milk banks. MNC was measured with near-infrared spectroscopy for 75 convenience samples from five milk banks collected during September 2016-July 2017. Concordance of measured MNC with labelled values was evaluated using three different thresholds: within ±20%, similar to FDA labelling standards for class II nutrients in foods; ±10%; and ±5%. Protein and caloric content differed significantly between measured and labelled values and varied significantly among milk banks. Measured caloric content ranged from 16.50 to 30.27 kcal/oz, with 89.3% of hcDHM samples within ±20%, 58.7% within ±10%, and 18.7% within ±5% of labelled content. MNC of hcDHM used in clinical practice shows variation that may result in differences from desired diet. The clinical implications of such differences are unexplored.

Role of Daily Milk Volume and Period of Lactation in Nutrient Content of Human Milk: Results from a Prospective Study.

Most studies assessing the macronutrient content of human milk are published retrospectively using analyzers that fail to determine sodium content and do not take into account the role of volume in milk composition. We aimed to describe macronutrient content and sodium content in human milk over time, observe any associations between them, and determine the factors associated with the evolution of milk composition. A prospective, longitudinal, monocentric study was undertaken. Contents of protein, fat, and lactose of 102 milk samples from 40 mothers were determined using a human milk analyzer and that of sodium with a flame spectrophotometer. Milk volumes along with clinical data were recorded. Protein content in the fourth quartile of volume was significantly lower than that in the first three, suggesting the existence of a volume threshold for protein content at approximately 445 mL. After multivariate analysis, it was found that maternal age, average volume, and lactation period remained significantly associated with protein content, maternal age remained significantly associated with fat content, and only average volume with sodium content. In consideration of previous findings along with our data, we suggest that extra care should be taken with fortification for feeding preterm infants when the mother’s milk volume is greater than 400–450 mL.

Breastmilk Macronutrient Levels and Infant Growth During the First Three Months: a Cohort Study

Objective: The first three months after birth is a critical time interval for growth and development. Breastmilk is a natural nutrition source for infants. However, studies on the practice of exclusive breastfeeding and infant growth tend to result in contradictions. The objective of this study was to investigate the correlation between breastmilk macronutrient levels and infant growth during the first three months. Methods: We conducted an observational cohort study at Universitas Airlangga Hospital from June-October 2018. Subjects were enrolled using total sampling. Infant anthropometry, as defined by body weight, body length, and head circumference, were measured. Breastmilk specimens were collected using a breast pump and then sent directly for analysis. Lactose, protein, fat, and total calorie levels were obtained using a human milk analyzer. Procedures were repeated three times, once per month. The Pearson correlation coefficient was used for statistical analysis. Results: Forty participants were enrolled in this study. There was a positive correlation between breastmilk total calories and head circumference growth during the first ( p = 0.039), second ( p = 0.020), and third month ( p = 0.020). Breastmilk protein level was positively correlated with body length ( p &lt; 0.05) and head circumference ( p &lt; 0.05) during the first month. There was no correlation between body weight and breastmilk macronutrients or total calories ( p &gt; 0.05). Conclusion: Breastmilk macronutrient levels correlate to infant growth in a unique pattern. Total calories and first month protein correlated positively with infant head circumference. However, calorie source, e.g., lactose or fat, did not correlate with infant body weight and length. Â

PENGARUH PENDAPATAN EKONOMI IBU MENYUSUI TEHADAP KWALITAS KOMPONEN MAKRONUTRIEN ASI

ABSTRACT&#x0D; Indonesian socioeconomic experienced a prolonged crisis, which causes families unable to got decent, good, and nutritious food due to rising prices soaring or decreasing the amount of individual income (Arisman, 2004). Individual income is one of the socio-economic factors that can affected family food security. Low economic income indicated poor family food security, where food consumption patterns of breastfeeding mothers will be disrupted and have an impact on the amount and composition of nutritional milk. Breast milk has a good nutritional component for babies. The macronutrient component of breast milk influenced the prosess of growth and development of infants. This research was analytic observational research type cross sectional study design through observations on all breastfeeding mothers with children aged 1-2 months in the work area of Wonoksumo health center to determine the effect of economic income of breastfeeding mothers on the quality of the macronutrient component of breast milk. Breastfeeding of macronutrient component of ASI research using MIRIS human milk analyzer tool and income variable were measured using questionnaires. The data analysis used Categorical Regression. The result of this research shows that there were influence of economic income on protein and fat component of breast milk (P=0,02, P=0,000). The conclusion of this study showed that economic income of nursing mothers can affected the components of protein and fat in breast milk. &#x0D; &#x0D; Keywords: Income, Brestfeeding mothers, Breast milk component&#x0D;

Comparative lipidomics analysis of human, bovine and caprine milk by UHPLC-Q-TOF-MS

Although infant formula represents an important human milk substitute, it has been shown to contain many different lipid structures compared to human milk. In this study, the lipidome and fatty acid composition of human, bovine and caprine milk were analyzed and compared. A total of 13 lipid classes (including TG, DG, SM, PC, Cer, HexCer, Hex2Cer, PE, PG, PS, PI, PA and CL) were analyzed. Human milk was richer in TG containing LA, SM containing ULCFA and PLs containing ARA, DHA and DGLA. Moreover, there were no differential DG and SM species between human and caprine milk. A total of 215 and 147 lipids were identified as potential biomarkers that could be used to further analyze differences in the biological properties of human, bovine and caprine milk. This comprehensive analysis will hopefully help in the design of infant formula more suitable for Chinese babies.

Optimizing the Use of Human Milk Cream Supplement in Very Preterm Infants: Growth and Cost Outcomes

An exclusive human milk-based diet has been shown to decrease necrotizing enterocolitis and improve outcomes for infants ≤1250 g birth weight. Studies have shown that infants who received an exclusive human milk diet with a donor-human milk-derived cream supplement (cream) had improved weight and length velocity when the cream was added to mother's own milk or donor-human milk when energy was <20 kcal/oz using a human milk analyzer. Our objective was to compare growth and cost outcomes of infants ≤1250 g birth weight fed with an exclusive human milk diet, with and without human milk cream, without the use of a human milk analyzer. Two cohorts of human milk-fed premature infants were compared from birth to 34 weeks postmenstrual age. Group 1 (2010-2011) received a donor-human milk fortifier, whereas Group 2 (2015-2016) received donor-human milk fortifier plus the commercial cream supplement, if weight gain was <15 g/kg/d. There was no difference in growth between the 2 groups for weight (P = 0.32) or head circumference (P = 0.90). Length velocity was greater for Group 1 (P = 0.03). The mean dose of donor-human milk fortifier was lower in Group 2 (P < 0.001). Group 2 saved an average of $2318 per patient on the cost of human milk products (P < 0.01). Infants receiving a human milk diet with cream supplementation for growth faltering achieve appropriate growth in a cost-effective feeding strategy.