Acta Pædiatrica ISSN 0803-5253

REGULAR ARTICLE

Expressing breast milk at home for 24-h periods provides viable samples for macronutrient analysis Sven-Harald Anderssen ([email protected], [email protected])1, Emma E. Løvlund1, Egil A. Nygaard1, Terje R. Selberg1, Ketil Størdal1,2 1.Department of Pediatrics, Sykehuset Østfold, Fredrikstad, Norway 2.Norwegian Institute of Public Health, Oslo, Norway

Keywords Fortification, Human milk, Infrared analyses, Macronutrients, Preterm infants Correspondence S.-H. Anderssen, Barneavdelingen, Sykehuset Østfold, Cicignongaten 19,1606 Fredrikstad, Norway. Tel: +4708600 Fax: +4769861341 Emails: [email protected] and [email protected] Received 30 April 2014; revised 22 July 2014; accepted 7 October 2014. DOI:10.1111/apa.12825 Previous publication: This article has never been published in any medical or other publication.

ABSTRACT Aim: This study aimed to evaluate the reproducibility of macronutrient measurements of domestic pooled human milk from mothers with preterm infants and to see how the results affected human milk fortifications. Methods: We asked 28 new mothers to express their breast milk for 24 h on two consecutive days and repeat the process at weekly intervals. The samples were analysed using mid-infrared technology to calculate the differences between the milk collected on two consecutive days for reproducibility and the total protein supply with standard fortification. Results: There was a significant linear correlation between the two consecutive days with regard to protein (r = 0.94, p < 0.001), lipids (r = 0.86, p < 0.001), lactose (r = 0.91, p < 0.001) and 24-h volume (r = 0.96, p < 0.001). The percentage of the samples that would provide a protein supply of 3.5–4.5 g/kg/d with a fortification of 0.6 and 1.2 g protein/100 mL at a volume of 170 mL/kg were 28% and 41%, respectively. Conclusion: The domestic pooling of 24-h expressed human milk for macronutrient analysis was a simple and reliable way of obtaining representative data. Standard fortification implies there is a risk of under- and over-nutrition, and individual fortification may improve the nutrition of preterm infants.

INTRODUCTION Optimal nutrition is critical for the growth and brain development of preterm infants (1–4). Most infants with a very low birth weight (VLBW) are initially given early parenteral nutrition until enteral feeding is established. When the preterm infants are exclusively fed enterally, standard practice is to provide either preterm formula or human milk with fortification. The nutrition committees of both the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the American Academy of Pediatrics emphasise that the optimal growth velocity should mimic the intrauterine foetal growth (5,6). ESPGHAN recommends that babies born with a birth weight of

Expressing breast milk at home for 24-h periods provides viable samples for macronutrient analysis.

This study aimed to evaluate the reproducibility of macronutrient measurements of domestic pooled human milk from mothers with preterm infants and to ...
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