Osmolality of fortified donor human milk: An experimental study.
critical care
enteral nutrition
pediatrics
Journal
JPEN. Journal of parenteral and enteral nutrition
ISSN: 1941-2444
Titre abrégé: JPEN J Parenter Enteral Nutr
Pays: United States
ID NLM: 7804134
Informations de publication
Date de publication:
22 Aug 2023
22 Aug 2023
Historique:
revised:
16
08
2023
received:
01
05
2023
accepted:
21
08
2023
pubmed:
23
8
2023
medline:
23
8
2023
entrez:
23
8
2023
Statut:
aheadofprint
Résumé
We quantify the osmolality of human milk fortified with human milk fortifiers (HMFs), powder infant formulas and protein additives. Commercial liquid HMFs and powder infant formulas were added to pasteurized pooled donor human milk in triplicate and stirred. The osmolality of unfortified and fortified human milk at 22, 24, 26, 27, 28, and 30 kcal/oz (0.73, 0.8, 0.87, 0.9, 0.93, and 1 kcal/ml, respectively) was determined using freezing-point depression. The osmolality of fortified human milk associated with energy density in a linear relationship regardless of the fortification strategies. Multiple liquid HMFs and every powder infant formula exceeded the osmolality threshold of 450 mOsm/kg H The osmolality of fortified human milk is highly variable and should be considered when selecting a fortifying agent for human milk.
Sections du résumé
BACKGROUND
BACKGROUND
We quantify the osmolality of human milk fortified with human milk fortifiers (HMFs), powder infant formulas and protein additives.
METHODS
METHODS
Commercial liquid HMFs and powder infant formulas were added to pasteurized pooled donor human milk in triplicate and stirred. The osmolality of unfortified and fortified human milk at 22, 24, 26, 27, 28, and 30 kcal/oz (0.73, 0.8, 0.87, 0.9, 0.93, and 1 kcal/ml, respectively) was determined using freezing-point depression.
RESULTS
RESULTS
The osmolality of fortified human milk associated with energy density in a linear relationship regardless of the fortification strategies. Multiple liquid HMFs and every powder infant formula exceeded the osmolality threshold of 450 mOsm/kg H
CONCLUSION
CONCLUSIONS
The osmolality of fortified human milk is highly variable and should be considered when selecting a fortifying agent for human milk.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Mead Johnson Nutrition
Informations de copyright
© 2023 The Authors. Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.
Références
Committee on Nutrition; Section on Breastfeeding; Committee on Fetus and Newborn. Donor Human Milk for the High-Risk Infant: Preparation, Safety, and Usage Options in the United States. Pediatrics. 2017;139(1):e20163440. doi:10.1542/peds.2016-3440
Arslanoglu S, Corpeleijn W, Moro G, et al. Donor human milk for preterm infants: current evidence and research directions. J Pediatr Gastroenterol Nutr. 2013;57(4):535-542. doi:10.1097/MPG.0b013e3182a3af0a
Arslanoglu S, Boquien CY, King C, et al. Fortification of human milk for preterm infants: update and recommendations of the European Milk Bank Association (EMBA) Working Group on Human Milk Fortification. Front Pediatr. 2019;7:76. doi:10.3389/fped.2019.00076
Pearson F, Johnson MJ, Leaf AA. Milk osmolality: does it matter? Arch Dis Child Fetal Neonatal Ed. 2013;98(2):F166-F169. doi:10.1136/adc.2011.300492
Ellis ZM, Tan HSG, Embleton ND, Sangild PT, van Elburg RM. Milk feed osmolality and adverse events in newborn infants and animals: a systematic review. Arch Dis Child Fetal Neonatal Ed. 2019;104(3):F333-F340. doi:10.1136/archdischild-2018-315946
Siripattanapipong P, Yangthara B, Ngerncham S. Effect of fortifiers on the osmolality of preterm human milk. Paediatr Int Child Health. 2019;39(4):275-278. doi:10.1080/20469047.2019.1575537
De Curtis M, Candusso M, Pieltain C, Rigo J. Effect of fortification on the osmolality of human milk. Arch Dis Child Fetal Neonatal Ed. 1999;81(2):F141-F143. doi:10.1136/fn.81.2.f141
Kreissl A, Zwiauer V, Repa A, et al. Effect of fortifiers and additional protein on the osmolarity of human milk: is it still safe for the premature infant? J Pediatr Gastroenterol Nutr. 2013;57(4):432-437. doi:10.1097/MPG.0b013e3182a208c7
Barness LA, Mauer AM, Holliday MA, et al. Commentary on breast-feeding and infant formulas, including proposed standards for formulas. Pediatrics. 1976;57(2):278-285.
Koltetzko BC, Domellof F, Poindexter M, Vain BB, van Goudoever NJB. Nutritional Care of Preterm Infants. Vol. 122. Karger; 2021.
Osterman M, Hamilton B, Martin JA, Driscoll AK, Valenzuela CP. Births: final data for 2020. Natl Vital Stat Rep. 2021;70(17):1-50.
Klein CJ. Nutrient requirements for preterm infant formulas. J Nutr. 2002;132(6 suppl 1):1395S-1577S. doi:10.1093/jn/132.6.1395S
Hay, Jr. WW, Hendrickson KC. Preterm formula use in the preterm very low birth weight infant. Semin Fetal Neonatal Med. 2017;22(1):15-22. doi:10.1016/j.siny.2016.08.005
Eidelman AI, Schanler RJ, Johnston M, et al; Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-e841. doi:10.1542/peds.2011-3552
Agostoni C, Buonocore G, Carnielli V, et al. ESPGHAN Committee on Nutrition. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010;50(1):85-91. doi:10.1097/MPG.0b013e3181adaee0
Hair AB, Scottoline B, Good M. Dilemmas in human milk fortification. J Perinatol. 2023;43(1):103-107. doi:10.1038/s41372-022-01502-6
Sauret A, Andro-Garçon MC, Chauvel J, et al. Osmolality of a fortified human preterm milk: the effect of fortifier dosage, gestational age, lactation stage, and hospital practices. Arch Pediatr. 2018;25(7):411-415. doi:10.1016/j.arcped.2018.08.006
Pascale JA, Mims LC, Greenberg MG, Alexander JB. Gastric response in low birth weight infants fed various formulas. Neonatology. 1978;34(3-4):150-154. doi:10.1159/000241118
Ramirez A, Wong WW, Shulman RJ. Factors regulating gastric emptying in preterm infants. J Pediatr. 2006;149(4):475-479. doi:10.1016/j.jpeds.2006.05.028
Yigit S, Akgoz A, Memisoglu A, Akata D, Ziegler EE. Breast milk fortification: effect on gastric emptying. J Matern Fetal Neonatal Med. 2008;21(11):843-846. doi:10.1080/14767050802287176
McClure RJ, Newell SJ. Effect of fortifying breast milk on gastric emptying. Arch Dis Child Fetal Neonatal Ed. 1996;74(1):F60-F62. doi:10.1136/fn.74.1.f60
Kanmaz HG, Mutlu B, Canpolat FE, et al. Human milk fortification with differing amounts of fortifier and its association with growth and metabolic responses in preterm infants. J Hum Lact. 2013;29(3):400-405. doi:10.1177/0890334412459903
Book LS, Herbst JJ, Atherton SO, Jung AL. Necrotizing enterocolitis in low-birth-weight infants fed an elemental formula. J Pediatr. 1975;87(4):602-605. doi:10.1016/s0022-3476(75)80835-3
Singh P, Thakur A, Dogra S, Garg P, Srivastav LM, Kler N. Comparison of osmolality of human milk after fortification with three different fortifiers. Curr Med Res Pract. 2017;7(3):81-83. doi:10.1016/j.cmrp.2017.02.003
Pereira-da-Silva L, Dias MPG, Virella D, Moreira AC, Serelha M. Osmolality of preterm formulas supplemented with nonprotein energy supplements. Eur J Clin Nutr. 2008;62(2):274-278. doi:10.1038/sj.ejcn.1602736
Pereira-da-Silva L, Pitta-Grós dias M, Virella D, Serelha M. Osmolality of elemental and semi-elemental formulas supplemented with nonprotein energy supplements. J Hum Nutr Diet. 2008;21(6):584-590. doi:10.1111/j.1365-277X.2008.00897.x
Miller SA, Czajka DM. The influence of dietary osmolarity on survival in the neonatal rat. Neonatology. 1967;11(3):197-203. doi:10.1159/000240066
Goldblum OM. Intragastric feeding in the neonatal dog. Its effect on intestinal osmolality. Am J Dis Child. 1981;135(7):631-633. doi:10.1001/archpedi.1981.02130310037013
Sun J, Li Y, Nguyen DN, et al. Nutrient fortification of human donor milk affects intestinal function and protein metabolism in preterm pigs. J Nutr. 2018;148(3):336-347. doi:10.1093/jn/nxx033
Lueschow SR, Kern SL, Gong H, et al. Feeding formula eliminates the necessity of bacterial dysbiosis and induces inflammation and injury in the paneth cell disruption murine NEC model in an osmolality-dependent manner. Nutrients. 2020;12(4):900. doi:10.3390/nu12040900