ABSTRACT
We measured the sodium content of donor human milk (DHM) and calculated the estimated intake at a feeding volume of 160 mL/kg/day. The mean sodium content of unfortified DHM was 102.0 mg/L (4.4 mEq). Because <1% of bovine-fortified samples met the recommended sodium content, infants born preterm who are fed predominantly DHM likely require additional sodium.
Subject(s)
Enterocolitis, Necrotizing , Infant, Premature , Animals , Cattle , Dietary Supplements , Food, Fortified , Humans , Infant , Infant, Newborn , Milk, Human , SodiumABSTRACT
The influence of milk-banking processes on nutrients in donor human milk (DHM) is largely unknown. Previous studies have measured nutrients between pools of DHM, but within-pool nutrient differences (between bottles from the same pool) have yet to be elucidated. The objective of this study was to gain a better understanding of the effect of different mixing characteristics on the distribution of fat, protein, IgA, and lysozyme in bottled, raw DHM. Pools of DHM were created in a laboratory setting according to published human milk-banking guidelines and assigned to a mixing treatment (mixing during bottling method, pooling container material, and refrigerated hold time). Four mixing protocols using glass pooling containers and a 1-h refrigerated hold time were tested: control (no mixing during bottling); manual-A (Man-A, hand swirl after pouring 3 bottles); manual-B (Man-B, hand swirl after pouring every bottle); and mechanical-G (Mech-G, continuous stirring with a magnet). As secondary objectives, we compared the effect of a glass and a plastic pooling container with mechanical mixing (mechanical-P, Mech-P), and compared refrigerated delays of 1 and 24 h before bottling with manual mixing (manual-A24, Man-A24). To control for differences in nutrient content, comparisons between treatments were made using absolute percent difference from the treatment-specific mean; and comparisons within a treatment were made using the ratio of fat content in a bottle to fat content in the first bottle of the same pool. We did not observe differences in nutrient distribution between Man-A, Man-B, and Mech-G in pools held for 1 h, but all were significantly different from the control for fat. There were no differences between glass or plastic pooling containers when mechanical mixing was used. Holding a pool in the refrigerator for 24 h before bottling created significantly greater fat distribution than holding a pool for 1 h. Outcomes were the result of controlled experiments. In summary, manual and mechanical mixing of 1,700-mL DHM pools produces similar fat and protein distributions when DHM is pooled and bottled after a 1-h hold time. When DHM is held for 24 h before bottling, more research is needed to determine the duration of initial mixing needed to reduce fat variability between bottles.
Subject(s)
Milk Banks , Milk, Human , Animals , Humans , Milk, Human/chemistry , Nutrients , Refrigeration , Tissue DonorsABSTRACT
OBJECTIVES: Determine how thaw stage and bag manipulation (folding and squeezing) influence the retention of fat and number of aerobic bacteria colony-forming units when decanting human milk (HM) from plastic storage bags. METHODS: Lactating women (nâ=â40) in the Greensboro, North Carolina area were recruited to provide fresh HM. Samples were equally divided and frozen in storage bags for 2 months. Two thaw stages (ice/liquid) and the use of bag manipulation (yes/no) were assessed. Fat was measured using ether extraction and bacteria were measured using plate enumeration. Paired t tests were used to compare the effects of thaw stage and bag manipulation on post-thaw fat content. Repeated measures analysis of variance was used to compare the effect of bag manipulation on pre- and post-thaw bacteria. RESULTS: Fat retention was not significantly different when thawing to liquid versus ice (mean differenceâ=â0.10âg/dL; nâ=â17 paired samples; Pâ=â0.07). Decanting with bag manipulation retained more fat than decanting without manipulation, but only when HM was thawed to liquid (mean differenceâ=â0.13âg/dL; nâ=â11 paired samples; Pâ=â0.005), not when HM was thawed to ice (Pâ=â0.47). Bag manipulation did not increase total aerobic bacteria for either thaw stage (Pâ=â0.49). CONCLUSIONS: Fat retention is influenced by the method of removing previously frozen HM from plastic storage bags. Folding and squeezing the storage bag when decanting HM thawed to a liquid state increases fat recovery without increasing bacterial contamination.
Subject(s)
Lactation , Milk, Human , Female , Freezing , Humans , North Carolina , PlasticsSubject(s)
Breast Feeding , Milk , Animals , Female , Humans , Infant , Infant Nutritional Physiological Phenomena , Milk, Human , NutrientsABSTRACT
Background: The impact of milk banking processes on macronutrient variability in donor human milk (DHM) is largely unknown. Objective: To gain a better understanding of fat and protein composition in DHM and assess potential relationships with modifiable milk bank processes. Methods: Samples of raw, pooled DHM were collected from 20 milk banks (n = 300) along with the following processing attributes: if macronutrient analysis was used to select donors for pooling (target pooling; yes/no), number of donors per pool, pooling container material (glass/plastic/other), and method for mixing during bottling (manual/mechanical). Fat and protein were assessed. Homoscedasticity was assessed and magnitude of the spread was quantified. Results: Fat ranged from 1.9 to 6.1 g/dL (n = 298) and protein ranged from 0.7 to 1.4 g/dL (n = 300). Variability in fat was significantly lower in samples that had been target pooled (p = 0.04), contained more donors per pool (p < 0.001), and had been mixed mechanically (p < 0.001). Variability in protein was significantly lower in samples that contained more donors per pool (p = 0.001). In a stratified analysis, increasing the number of donors per pool only reduced nutrient variability in samples that were not target pooled. Conclusion: For milk banks that do not target pool, using a greater number of donors in a pool may reduce fat and protein variability.