Comparing human milk macronutrients measured using analyzers based on mid-infrared spectroscopy and ultrasound and the application of machine learning in data fitting

Abstract

Objective Fat, carbohydrates (mainly lactose) and protein in breast milk all provide indispensable benefits for the growth of newborns. The only source of nutrition in early infancy is breast milk, so the energy of breast milk is also crucial to the growth of infants. Some macronutrients composition in human breast milk varies greatly, which could affect its nutritional fulfillment to preterm infant needs. Therefore, rapid analysis of macronutrients (including lactose, fat and protein) and milk energy in breast milk is of clinical importance. This study compared the macronutrients results of a mid-infrared (MIR) analyzer and an ultrasound-based breast milk analyzer and unified the results by machine learning. Methods This cross-sectional study included breastfeeding mothers aged 22–40 enrolled between November 2019 and February 2021. Breast milk samples (n = 546) were collected from 244 mothers (from Day 1 to Day 1086 postpartum). A MIR milk analyzer (BETTERREN Co., HMIR-05, SH, CHINA) and an ultrasonic milk analyzer (Honɡyanɡ Co,. HMA 3000, Hebei, CHINA) were used to determine the human milk macronutrient composition. A total of 465 samples completed the tests in both analyzers. The results of the ultrasonic method were mathematically converted using machine learning, while the Bland-Altman method was used to determine the limits of agreement (LOA) between the adjusted results of the ultrasonic method and MIR results. Results The MIR and ultrasonic milk analyzer results were significantly different. The protein, fat, and energy determined using the MIR method were higher than those determined by the ultrasonic method, while lactose determined by the MIR method were lower (all p < 0.05). The consistency between the measured MIR and the adjusted ultrasound values was evaluated using the Bland-Altman analysis and the scatter diagram was generated to calculate the 95% LOA. After adjustments, 93.96% protein points (436 out of 465), 94.41% fat points (439 out of 465), 95.91% lactose points (446 out of 465) and 94.62% energy points (440 out of 465) were within the LOA range. The 95% LOA of protein, fat, lactose and energy were - 0.6 to 0.6 g/dl, -0.92 to 0.92 g/dl, -0.88 to 0.88 g/dl and - 40.2 to 40.4 kj/dl, respectively and clinically acceptable. The adjusted ultrasonic results were consistent with the MIR results, and LOA results were high (close to 95%). Conclusions While the results of the breast milk rapid analyzers using the two methods varied significantly, they could still be considered comparable after data adjustments using linear regression algorithm in machine learning. Machine learning methods can play a role in data fitting using different analyzers.

Sleep duration of lactating mothers and its relationship with feeding pattern, milk macronutrients and related serum factors: A combined longitudinal cohort and cross-sectional study

“…They were included into the cross-sectional or longitudinal cohort based on the recruitment inclusion and exclusion criteria and the subjects' wishes. Before starting the study, we used a sample size calculator ( http://powerandsamplesize.com/Calculators/Compare-k-Means/1-Way-ANOVA-Pairwise , power = 0.80; α = 0.05; G = 3) and the recommendations from previous studies to determine the number of people that would have to be recruited ( 27 – 29 ). For the initial step, we identified 123 mothers in the longitudinal cohort, of which 115 were eventually included.…”

“…Therefore, this study began in December 2019 and ended in December 2021. Additional information on the participant population is available in the previous studies ( 27 , 28 ). The inclusion and exclusion criteria for the longitudinal cohort and the cross-sectional study are as follows:…”

“…Breast milk collection, transportation, and storage have been discussed in previous studies ( 30 , 31 ). More details about breast milk collection can be found in the previous works of literatures ( 27 , 28 ).…”

Longitudinal Changes in Body Weight of Breastfeeding Mothers in the First Year after Delivery and its Relationship with Human Milk Composition: a Combined Longitudinal and Cross-sectional Cohort Study

“…The collected milk was stored in a lab freezer at -80 ℃ until further analysis, and this process was performed for each milk sample collection. For more details on the collection process, transportation, and human milk storage, refer to the previous studies (25,(33)(34)(35).…”

“…In this study, we used a milk analyzer (BETTERREN Co., HMIR-05, SH, CHINA) based on the mid-infrared spectroscopy (MIRS) method to determine lactose (g/dl), protein (g/dl), and fat (g/dl), as well as energy (kJ/dl) in the human milk (34,(36)(37)(38). The instrument used was patented by the State Intellectual Property Office of the People's Republic of China (CN 108760671 A) in 2018.…”