Document Detail

Design and characterization of a human milk product for the preterm infant.
MedLine Citation:
PMID:  19929699     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It is necessary to fortify human milk to promote optimal growth of the very preterm infant. However, the addition of non-human milk components to human milk is not ideal because of the risk of feeding intolerance and necrotizing enterocolitis. Human milk products (HMP) are an alternative to commercially available fortifiers, but their preparation is likely to result in modifications to the qualities of human milk. METHODS: Ten batches of HMP were prepared with the aim of meeting a desired protein:energy ratio of 3.0 g of protein/100 kcal. Ultrafiltration was used to produce a skim milk concentrate, to which cream was then added to produce the final HMP. Characterization of HMP and human milk fortified with commercial human milk fortifiers (Nutriprem [Cow & Gate, Limerick, Ireland] and S-26 SMA human milk fortifier [Wyeth Nutrition, Baulkham Hills, NSW, Australia]) included quantifying macronutrient content, osmolality, microbial content, and particle distribution. RESULTS: Average protein:energy ratio of the final batch was 2.93 +/- 0.10 g of protein/100 kcal, equating to an inaccuracy of 2.5% relative to the desired ratio of 3.0 g of protein/100 kcal. Significantly greater fat (P < 0.01), lower lactose (P < 0.001), and lower osmolality (P < 0.001) were characteristic of the HMP compared to human milk fortified with either commercial fortifier. Microbial growth occurred during preparation of HMP but did not exceed 10(5) colony-forming units/mL, and pasteurization of human milk prevented contamination in 80% of batches. CONCLUSIONS: HMP can be designed to accurately target the protein and energy requirements of the preterm infant, but modifications of the macronutrient, biochemical, structural, and microbial characteristics of human milk may affect the quality of the final product.
Charles Czank; Karen Simmer; Peter E Hartmann
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine     Volume:  5     ISSN:  1556-8342     ISO Abbreviation:  Breastfeed Med     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-09     Completed Date:  2010-06-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101260777     Medline TA:  Breastfeed Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  59-66     Citation Subset:  IM    
Discipline of Biochemistry and Molecular Biology, School of Biomedical, Biomolecular, and Chemical Science, The University of Western Australia, Crawley, Western Australia, Australia.
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MeSH Terms
Dietary Fats / administration & dosage*,  analysis
Energy Intake
Food Contamination / analysis
Food, Fortified*
Infant, Newborn
Infant, Premature / growth & development*
Lactose / administration & dosage,  analysis
Milk Proteins / administration & dosage*,  analysis
Milk, Human / chemistry*,  microbiology
Nutritional Requirements
Osmolar Concentration
Weight Gain
Reg. No./Substance:
0/Dietary Fats; 0/Milk Proteins; 63-42-3/Lactose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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