Document Detail


Routine handling of milk fed to preterm infants can significantly increase osmolality.
MedLine Citation:
PMID:  12352516     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of these studies was to evaluate the changes in osmolality which occur in human breast milk or formula after two modifications; these changes are sometimes used in preparing these milks for consumption by premature infants, namely, the addition of fortifiers and the addition of exogenous lactase enzyme. METHODS: The osmolality of expressed, previously frozen human breast milk, breast milk fortified with commercial fortifiers, liquid formulas, powdered formulas, or glucose polymers was measured. Osmolality was measured before and after warming (15 minutes at 37 degrees C) or after refrigeration at 4 degrees C for 12 hours with subsequent warming. In a second group of experiments, the osmolality of expressed breast milk and three lactose-containing formulas was measured before and after incubation with lactase (Lactaid ) at 4 degrees C for 2, 6, and 24 hours. RESULTS: Warming of breast milk mixed with some of the additives was associated with a significant increase in osmolality. The additives which increased osmolality included liquid glucose polymers, two commercially available powdered human milk fortifiers, and three formulas which contain glucose polymers (a protein hydrolysate infant formula powder, powdered lactose free formula, and a powdered preterm formula). Maximum increase in osmolality of breast milk occurred with the addition of 20 ml/100ml liquid glucose polymers (Polycose, Ross Laboratories) which resulted in a 21% increase in osmolality after refrigeration and warming. The addition of liquid glucose polymers and of powdered preterm formulas containing glucose polymers (Enfacare, Mead Johnson, 9.5 g/100ml and Nutramigen, Mead Johnson, 6 g/100ml) resulted in a final osmolality of over 425 mOsmol/L. The addition of lactase and subsequent incubation under refrigeration resulted in significant increases in osmolality that ranged from 25 to 66% in fortified breast milks and lactose-containing formulas. Incubation of these milks at 37 degrees for 15 minutes produced about 50% greater increase in osmolality than observed after 2 hours of incubation under refrigeration. CONCLUSIONS: Routine warming of breast milk with glucose polymer-containing additives, or the addition of lactase enzyme to lactose-containing feedings, can increase osmolality to levels that exceed current guidelines for premature infant feedings.
Authors:
Tanis R Fenton; Jaques Belik
Related Documents :
22142966 - Adverse birth outcomes and maternal exposure to trichloroethylene and tetrachloroethyle...
6683486 - Determinants of variations in breast milk protective factor concentrations of rural gam...
11720696 - Fluoxetine and norfluoxetine concentrations in nursing infants and breast milk.
16183356 - Fortifying fresh human milk with commercial powdered human milk fortifiers does not aff...
1790026 - Ultrastructural investigations in late infantile type of ceroid lipofuscinosis (jansky-...
7058446 - Features predictive of brachial plexus injury during labour.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  35     ISSN:  0277-2116     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-27     Completed Date:  2003-01-17     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  298-302     Citation Subset:  IM    
Affiliation:
Clinical Nutrition Services and Neonatal Intensive Care Unit, Calgary Health Region, Foothills Medical Centre, 140329 Street NW, Calgary, Alberta, Canada T2N 2T9. tanisfenton@shaw.ca
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Dietary Carbohydrates / administration & dosage
Food Handling*
Food, Fortified
Hot Temperature
Humans
Infant Food*
Infant, Newborn
Infant, Premature / physiology*
Lactase
Milk, Human*
Osmolar Concentration*
Refrigeration
Time Factors
beta-Galactosidase / administration & dosage
Chemical
Reg. No./Substance:
0/Dietary Carbohydrates; EC 3.2.1.108/Lactase; EC 3.2.1.23/beta-Galactosidase

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


Previous Document:  Effects of intrauterine growth restriction and intraamniotic insulin-like growth factor-I treatment ...
Next Document:  Assay of tracheal pepsin as a marker of reflux aspiration.