Variability in human milk composition: benefit of individualized fortification in very-low-birth-weight infants

Halleux, Virginie de; Rigo, Jacques

doi:10.3945/ajcn.112.042689

Cited by 122 publications

(136 citation statements)

References 52 publications

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“…Energy and especially protein contents are low in the majority of samples and routine fortification of preterm human milk fails to meet the recommended nutritional intake 37. This fact, together with the data obtained from previous studies, enhances the need for target fortification of preterm milk and perhaps the development of new breast milk fortifiers with appropriately higher content of protein and energy.…”

Section: Discussionmentioning

confidence: 99%

Preterm human milk macronutrient concentration is independent of gestational age at birth

Malý

Burianová

Vítková

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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Section: Discussionmentioning

confidence: 99%

Preterm human milk macronutrient concentration is independent of gestational age at birth

Malý

Burianová

Vítková

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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“…Adequate protein intake is essential for preterm infants given their rapid rate of weight gain and anabolism, so the limited protein content in DHM is a concern. As with preterm MOM, protein and energy deficits are corrected with fortification; however, more fortification may be required for DHM to compensate for its low mean protein content (73). Furthermore, the heating process of pasteurization can denature proteins and immunologic agents in DHM (74), possibly reducing the effectiveness of DHM in developing a preterm infant's gut and immune systems.…”

Section: Sources Of Nutritionmentioning

confidence: 99%

Current Knowledge of Necrotizing Enterocolitis in Preterm Infants and the Impact of Different Types of Enteral Nutrition Products

Shulhan¹,

Dicken²,

Hartling³

et al. 2017

Advances in Nutrition

105

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Preterm infants are extremely vulnerable to a range of morbidities and mortality. Underdeveloped cardiac, respiratory, gastrointestinal, and immune systems in the preterm period increase the risk of necrotizing enterocolitis (NEC), a serious disease of the gut. NEC affects 5-12% of very-low birthweight infants, leads to surgery in 20-40% of cases, and is fatal in 25-50% of cases. There are multiple factors that may contribute to NEC, but the exact cause is not yet fully understood. Severe cases can result in intestinal resection or death, and the health care costs average >$300,000/infant when surgical management is required. Different types of nutrition may affect the onset or progression of NEC. Several studies have indicated that bovine milk-based infant formulas lead to a higher incidence of NEC in preterm infants than does human milk (HM). However, it is not clear why HM is linked to a lower incidence of NEC or why some infants fed an exclusively HM diet still develop NEC. An area that has not been thoroughly explored is the use of semielemental or elemental formulas. These specialty formulas are easy to digest and absorb in the gut and may be an effective nutritional intervention for reducing the risk of NEC. This review summarizes what is known about the factors that contribute to the onset and progression of NEC, discusses its health care cost implications, and explores the impact that different formulas and HM have on this disease. Adv Nutr 2017;8:80-91.

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“…Since then, this value has been confirmed by several recent studies on donor breast milk or own mother's milk (mean ± standard deviation (SD)): 65  11 kcal/100 mL for donor breast milk (Wojcik et al, 2009); 67.3  6.5 kcal/100 mL for own mother's milk, 64.1  5.9 kcal/100 mL for single-donor pooled breast milk, 63.6  4.5 kcal/100 mL for multiple-donor pooled breast milk (de Halleux and Rigo, 2013); 62 ± 9.6 kcal/100 mL to 65 ± 9.1 kcal/100 mL for own mother's milk (Nielsen et al, 2011) and 66 ± 12 kcal/100 mL for donor breast milk (Cooper et al, 2013).…”

Section: Energy Density Of Human Milkmentioning

confidence: 99%

Scientific Opinion on the essential composition of infant and follow-on formulae

Products¹

2014

EFSA Journal

280

124

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Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver a scientific opinion on the essential composition of infant and follow-on formula. This opinion reviews the opinion provided by the Scientific Committee on Food in 2003 on the essential requirements of infant and follow-on formulae in light of more recent evidence and by considering the Panel's opinion of October 2013 on nutrient requirements and dietary intakes of infants and young children in the European Union. The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first six months of life in its previous opinion and an average amount of formula consumed during this period. From a nutritional point of view, the minimum contents of nutrients in infant and follow-on formula proposed by the Panel cover the nutritional needs of virtually all healthy infants born at term and there is no need to exceed these amounts in formulae, as nutrients which are not used or stored have to be excreted and this may put a burden on the infant's metabolism. Therefore, the Panel emphasises that maximum amounts should be interpreted not as target values but rather as upper limits of a range which should not be exceeded. There is scientific consensus that breast milk is the preferred food for all healthy infants and provides an adequate supply of all nutrients to support growth and development (with the exception of vitamin K during the first weeks of life and of vitamin D). Whereas the composition of infant formula remains stable over time, breast milk composition changes continuously and therefore infant formula cannot imitate breast milk. © EuropeanAll formulae intended for infants must be safe and suitable to meet the nutritional requirements and promote growth and development of infants born at term when used as a sole source of nutrition during the first months of life, and when used as the principal liquid element in a progressively diversified diet after the introduction of appropriate complementary feeding. Nutrients and substances should be added to formulae for infants only in amounts that serve a nutritional or other benefit. The addition in amounts higher than those serving a benefit or the inclusion of unnecessary substances in formulae may put a burden on the infant's metabolism and/or on other physiological functions, as substances which are not used or stored have to be excreted.The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first half of the first year of life in its previous opinion and an average amount of daily energy intake from formula during this period (500 kcal/day). These minimum amounts should be understood as target values which cover the nutritional needs of virtually all infants born at term for optimal growth and devel...

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Variability in human milk composition: benefit of individualized fortification in very-low-birth-weight infants

Cited by 122 publications

References 52 publications

Preterm human milk macronutrient concentration is independent of gestational age at birth

Preterm human milk macronutrient concentration is independent of gestational age at birth

Current Knowledge of Necrotizing Enterocolitis in Preterm Infants and the Impact of Different Types of Enteral Nutrition Products

Scientific Opinion on the essential composition of infant and follow-on formulae

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