Macronutrient variability in human milk from donors to a milk bank: Implications for feeding preterm infants
| Autor: | Ruichen (Richard) Sun, Lisa M. Maillart, Maryanne T Perrin, Ashley John, Andrew J. Schaefer, Erin Hamilton Spence |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Calorie
Physiology Pooling Lactose Disaccharides Biochemistry Physical Chemistry Fats Families chemistry.chemical_compound Endocrinology Spectrum Analysis Techniques 0302 clinical medicine Nutrient Reproductive Physiology Lactation Medicine and Health Sciences 030212 general & internal medicine Infant Nutritional Physiological Phenomena Breast Milk Children 2. Zero hunger Multidisciplinary Organic Compounds Fourier Transform Infrared Spectroscopy Lipids Body Fluids Chemistry Milk medicine.anatomical_structure Physical Sciences Food Fortified Engineering and Technology Medicine Female Anatomy Infants Infant Premature Research Article Science Fortification Carbohydrates Infrared Spectroscopy Breast milk Biology Research and Analysis Methods Beverages 03 medical and health sciences Animal science 030225 pediatrics medicine Humans Milk Banks Nutrition Retrospective Studies Endocrine Physiology Milk Human Surface Treatments Organic Chemistry Chemical Compounds Infant Newborn Nutritional Requirements Biology and Life Sciences Infant Diet Chemical Deposition Manufacturing Processes chemistry Age Groups People and Places Population Groupings Energy Intake |
| Zdroj: | PLoS ONE, Vol 14, Iss 1, p e0210610 (2019) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Background and objective: The composition of human milk varies widely and impacts the ability to meet nutrient requirements for preterm infants. The purpose of this study is to use a large dataset of milk composition from donors to a milk bank to: (1) describe the macronutrient variability in human milk and how it contributes to the ability to meet the protein and calorie targets for the preterm infant using fortification with commercially available multi-nutrient fortifiers; (2) assess how temporal versus subject effects explain macronutrient variability; (3) determine how macronutrient variability contributes to the nutrient distribution in pooled donor milk. Methods: This is a retrospective, observational study that analyzes the macronutrient data of 1,119 human milk samples from 443 individual donors to a milk bank. We test fortification strategies with potential basic, intermediate, and high protein and calorie commercial fortifiers. Additionally, we simulate the random pooling of multiple donors to model the impact of macronutrient variability on pooled donor milk. Results: Fat was the most variable nutrient and accounted for 80% of the difference in calories. A subject-effect predicted more of the variability after 4 weeks postpartum in all macronutrients (R2 > = 0.50) than a time-effect (R2 < = 0.28). When pooling multiple donors, variability was reduced by increasing the number of donors randomly selected for a pool or targeted pooling based on macronutrient analysis of donor pools. Over 75% of mature milk samples fortified with a basic protein fortifier did not meet daily protein targets of 3.5 g/kg without exceeding volumes of 160 ml/kg/day. Conclusion: There is a strong individual signature to human milk that impacts the pooling of donor milk, and the ability to meet protein and energy requirements for the preterm infant with basic and intermediate protein and calorie fortifiers. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|