“Bed Side” Human Milk Analysis in the Neonatal Intensive Care Unit

Fusch, Gerhard; Kwan, Celia; Kotrri, Gynter; Fusch, Christoph

doi:10.1016/j.clp.2016.11.001

Cited by 42 publications

(33 citation statements)

References 62 publications

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“…A 3-mL sample was analyzed during each measurement using a Miris human milk analyzer (HMA). The Miris HMA has been proven to be a reliable and helpful tool for bedside analysis of human milk based on mid-infrared transmission spectroscopy [19][20][21][22]. A check procedure with zero level adjustment and a replicate samples control were the required quality controls for Miris HMA.…”

Section: Human Milk Analysismentioning

confidence: 99%

The association of macronutrients in human milk with the growth of preterm infants

et al. 2020

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Background Breast milk is the optimal choice for feeding premature babies. However, the prevalence rate of extrauterine growth restriction in preterm infants remains high. Objectives The purpose of this study was to analyze the macronutrients present in human milk and the correlation with the growth of in-hospital preterm infants. Methods This prospective study is based on data from 99 in-hospital preterm infants younger than 37 weeks of gestational age on an exclusively human milk diet. Infants who had previously received parenteral nutrition were eligible, but they had to have reached full enteral feeding at the time that the samples were taken. A total of 3282 samples of raw human milk or donor pasteurized milk were collected. The levels of lactose, protein, fat, and energy in the samples were measured using a Miris human milk analyzer. The primary outcome was weight growth velocity (g/kg/day) which was obtained using two-point approach. Results The mean (±standard deviation) macronutrient composition per 100 mL of milk was 7.2 (±0.3) g of lactose, 1.1 (±0.2) g of true protein, 3.5 (±0.9) g of fat, and 66.9 (±6.5) kcal of energy. The protein concentration in human milk had a positive, significant correlation with body weight gain, with a coefficient of 0.41 (p < 0.001). After adjusting for gestational age, postmenstrual age, small-for-gestational age, intraventricular hemorrhage, patent ductus arteriosus or congestive heart failure, duration of total parenteral nutrition support, bottle feeding or use of orogastric tube, and ventilator support, total daily protein intake was associated with body weight growth (p < 0.001).

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Section: Human Milk Analysismentioning

confidence: 99%

The association of macronutrients in human milk with the growth of preterm infants

et al. 2020

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“…Several investigators have evaluated the MIRIS HMA, with variable and conflicting results in precision and accuracy compared with reference biochemical macronutrient determination techniques (24)(25)(26)(27)(28)(29) . Many studies have demonstrated good precision with the MIRIS HMA in fat and protein but not in lactose determination (25,26,28) ; this may be due to the presence of oligosaccharides in significant numbers in human milk which cannot be differentiated from lactose by the IR technology (30,31) . For this reason, values for carbohydrate content rather than lactose are presented here.…”

Section: Milk Analysismentioning

confidence: 99%

“…For this reason, values for carbohydrate content rather than lactose are presented here. Other reasons for the lack of consistency in studies evaluating the MIRIS HMA include discrepancies in the choice of chemical reference method for macronutrient measurement, the size and characteristic of the sample set and sample preparation before measurement (31) . Differences in the model and software version of MIRIS HMA could also be a factor, as recently shown by Buffin et al (32) .…”

Section: Milk Analysismentioning

confidence: 99%

Macronutrient content of donor milk from a regional human milk bank: variation with donor mother–infant characteristics

Mills

Coulter²,

Savage³

et al. 2019

Br J Nutr

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Better understanding of the variation in macronutrient content of human donor milk (HDM) potentiates targeted nutrition for preterm babies. The present study describes the relationship of maternal age, parity, monthly lactation stage estimate (LSEm), daily volume of milk expressed (Vd), sex, gestation and birth weight z scores with macronutrient content of HDM. Multilevel mother–infant pair ID random intercept models were performed using the predictor variables above on the outcome HDM macronutrient content determined using mid-IR spectroscopy. Mean macronutrient content was also compared by gestational age and small for gestational age (SGA) (z score < –1·28) or appropriate for gestational age (AGA) (z score ≥ –1·28) categories. A total of 2966 samples of donations from 1175 mother–infant pairs to the UK Northwest Human Milk Bank between 2011 and 2017 were analysed. Mean protein, fat, carbohydrate and calculated energy were 0·89 (SD 0·24) g/dl, 2·99 (SD 0·96) g/dl, 7·09 (SD 0·44) g/dl, and 60·37 (SD 8·41) kcal/dl (252·59 (SD 35·19) kJ/dl), respectively. Preterm SGA HDM was significantly higher in protein, fat and energy content than term AGA HDM and significantly lower in carbohydrate content than term AGA HDM after controlling for LSEm, Vd and between-subject effects. Degree of prematurity did not influence macronutrient content. Between-subject effects accounted for more of the variance in macronutrient content than the fixed effects in the model. Despite this, SGA status, as well as prematurity, may be an important determinant of macronutrient content in human milk. As bioavailability of macronutrients from HDM is uncertain, studies evaluating growth and body composition in preterm and SGA babies fed HDM are warranted.

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“…The known high variability in HM composition makes standard calculation of nutrient intake inaccurate, with risk of underestimation or overestimation of actual energy and macronutrient intake. Analysis of carbohydrate component and calculated caloric density of HM is confounded by the presence of both lactose and oligosaccharides . MIR analysis measures infrared or heat energy absorbed by the sample; therefore, thawing and temperature of the sample needs to be well controlled.…”

Section: Discussionmentioning

confidence: 99%

Tolerance of Hydrolyzed Liquid Protein Fortified Human Milk and Effect on Growth in Premature Infants

et al. 2018

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Background: We evaluated tolerance of hydrolyzed liquid protein (LP) supplement added to fortified human milk (HM) to optimize protein intake in preterm infants. Methods: A prospective observational study of 31 subjects compared with 31 historic controls, receiving mothers own milk (MOM) and/or donor milk (DM) to assess LP tolerance, growth, and risk for morbidities was conducted. Milk was analyzed for nutrient content. Feeding intolerance, defined as cessation of feedings for ࣙ48 hours, abdominal distension and/or residuals, necrotizing enterocolitis (NEC), and metabolic acidosis were used to assess safety, while weight and head circumference (HC) were used to evaluate growth. Results: LP added to powder-fortified HM had no impact on feeding intolerance and NEC. Biochemical parameters showed no metabolic acidosis: blood urea nitrogen levels (first week: median, 13 mg/dL; interquartile range [IQR], 9-16; last week: median, 13 mg/dL; IQR, 10.3-14; P = .94), bicarbonate levels (first week: median, 26.3 mEq/L; IQR, 24-28; last week: median, 28 mEq/L; IQR, 26.3-29.8; P = .10), and pH levels (first week: median, 7.4; IQR, 7.3-7.4; last week: median, 7.4; IQR, 7.37-7.40; P = .5). Weight and HC were not statistically significant. HM analysis showed lower protein and caloric content, respectively (MOM: 0.88 vs DM: 0.77 g/100 mL; P < .0001 and MOM: 18.68 vs DM: 17.96 kcal/oz; P = .02). Conclusions: Hydrolyzed LP is well tolerated in preterm infants with no difference in growth rates. Clinicians should focus on the need to maximize both protein and energy to optimize growth. (Nutr Clin Pract. 2019;34:450-458) Keywords enteral nutrition; human milk; infant; protein supplement From the

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“Bed Side” Human Milk Analysis in the Neonatal Intensive Care Unit

Cited by 42 publications

References 62 publications

The association of macronutrients in human milk with the growth of preterm infants

The association of macronutrients in human milk with the growth of preterm infants

Macronutrient content of donor milk from a regional human milk bank: variation with donor mother–infant characteristics

Tolerance of Hydrolyzed Liquid Protein Fortified Human Milk and Effect on Growth in Premature Infants

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