Top

Published in:

Open Access 01-12-2019 | Research article

Macronutrient content of pooled donor human milk before and after Holder pasteurization

Authors: Pasqua Piemontese, Domenica Mallardi, Nadia Liotto, Chiara Tabasso, Camilla Menis, Michela Perrone, Paola Roggero, Fabio Mosca

Published in: BMC Pediatrics | Issue 1/2019

Abstract

Background

Donor human milk (DHM) is the best alternative for preterm infants when their own mother’s milk is unavailable. DHM should be pasteurized to guarantee microbiological safety; however, this process can influence the macronutrient content.

The aim of this study was to investigate the effect of Holder pasteurization (HoP) on DHM macronutrient content.

Methods

Protein, lactose, lipids (g/100 ml) and energy (kcal/100 ml) of DHM pools were analysed before and after HoP (62.5 °C for 30 min) using mid-infrared spectroscopy (HM analyser Miris AB®). The mean macronutrient content before and after HoP was compared by paired t-test. The percentage decreases (Delta%) were calculated.

Results

The change in macronutrient content of 460 pools was determined. Protein, lipids and lactose decreased significantly after HoP (0.88 ± 0.20 vs 0.86 ± 0.20 and 2.91 ± 0.89 vs 2.75 ± 0.84 and 7.19 ± 0.41 vs 7.11 ± 0.48 respectively). The Delta% values were − 2.51 ± 13.12, − 4.79 ± 9.47 and − 0.92 ± 5.92 for protein, lipids and lactose, respectively (p ≤ 0.001).

Conclusion

This study confirms that the macronutrient content of DHM, especially in terms of lipids and protein, is reduced after HoP. Therefore, in order to perform a tailored fortification of DHM, the clinicians need to be aware of the somewhat diminished nutrient content of DHM.

American Academy of Pediatrics section of breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129:827–41.

Senterre T. Practice of enteral nutrition in very low birth weight and extremely birth weight infants. World Rev Nutr Diet. 2014;110:201–14. https://doi.org/10.1159/000358468. CrossRefPubMed

Quigley MA, Henderson G. Formula milk versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev. 2017. https://doi.org/10.1002/14651858.CD002971.

Hair AB, Peluso AM, Hawthorne KM, Perez J, Smith DP, Khan JY, et al. Beyond necrotizing enterocolitis prevention: improving outcomes with an exclusive human Milk–based diet. Breastfeed Med. 2016;11:70–4. https://doi.org/10.1089/bfm.2015.0134.CrossRefPubMedPubMedCentral

Villamor-Martínez E, Pierro M, Cavallaro G, Mosca F, Kramer BW, Villamor E. Donor human Milk protects against bronchopulmonary dysplasia: a systematic review and meta-analysis. Nutrients. 2018;10. https://doi.org/10.3390/nu10020238.

Assad M, Elliott MJ, Abraham JH. Decreased cost and improved feeding tolerance in VLBW infants fed an exclusive human milk diet. J Perinatol. 2016;36:216–20. https://doi.org/10.1038/jp.2015.168. CrossRefPubMed

Italian Association of Human Milk Banks (AIBLUD). Guidelines for the establishment and operation of a donor human milk bank. J Matern Fetal Neonatal Med. 2010;23:1–20. https://doi.org/10.3109/14767058.2010.512414.CrossRef

Human Milk Banking Association of North America (HMBANA). Guidelines for the establishment and operation of a donor human Milk Bank. 9th ed. Raleigh: Human Milk Banking Association of North America; 2015.

Rede Brazileira do Bancos de Leite Humano. Banco de leite humano: funcionamento, prevenção e controle de riscos. Brazilia: Agência Nacional de Vigilância Sanitária; 2008.

10.

Peila C, Moro GE, Bertino E, Cavallarin L, Giribaldi M, Giuliani F, et al. The effect of holder pasteurization on nutrients and biologically-active components in donor human Milk: a review. Nutrients. 2016;8. https://doi.org/10.3390/nu8080477.

11.

Mangili G, Garzoli E. Feeding of preterm infants and fortification of breast milk. La Pediatr Med Chir. 2017;39:158. https://doi.org/10.4081/pmc.2017.158. CrossRef

12.

Adhisivam B, Vishnu Bhat B, Rao K, Kingsley SM, Plakkal N, Palanivel C. Effect of holder pasteurization on macronutrients and immunoglobulin profile of pooled donor human milk. J Matern Fetal Neonatal Med. 2018:1–4. https://doi.org/10.1080/14767058.2018.1455089.

13.

O’Connor DL, Ewaschuk JB, Unger S. Human milk pasteurization: benefits and risks. Curr Opin Clin Nutr Metab Care. 2015;18:269–75. https://doi.org/10.1097/MCO.0000000000000160.CrossRefPubMed

14.

Peila C, Coscia A, Bertino E, Cavaletto M, Spertino S, Icardi S, Tortone C, Visser GH, Gazzolo D. Effects of Holder pasteurization on the protein profile of human milk. Ital J Pediatr. 2016;42:36. https://doi.org/10.1186/s13052-016-0248-5.

15.

Arslanoglu S, Bertino E, Tonetto P, De Nisi G, Ambruzzi AM, Biasini A, et al. For Italian Association of Human Milk Banks Associazione Italiana Banche del latte Umano Donato (AIBLUD: www.aiblud.org). Guidelines for the establishment and operation of a donor human milk bank. J Matern Fetal Neonatal Med. 2010;23:1–20. https://doi.org/10.3109/14767058.2010.512414. CrossRefPubMed

16.

Casadio YS, Williams TM, Lai CT, Olsson SE, Hepworth AR, Hartmann PE. Evaluation of a mid-infrared analyzer for the determination of the macronutrient composition of human milk. J Hum Lact. 2010;26:376–83. https://doi.org/10.1177/0890334410376948. CrossRefPubMed

17.

Vieira AA, Soares FV, Pimenta HP, Abranches AD, Moreira ME. Analysis of the influence of pasteurization, freezing/thawing, and offer processes on human milk’s macronutrient concentrations. Early Hum Dev. 2011;87:577–80. https://doi.org/10.1016/j.earlhumdev.2011.04.016.CrossRefPubMed

18.

García-Lara NR, Vieco DE, De la Cruz-Bértolo J, Lora-Pablos D, Velasco NU, Pallás-Alonso CR. Effect of holder pasteurization and frozen storage on macronutrients and energy content of breast milk. J Pediatr Gastroenterol Nutr. 2013;57:377–82. https://doi.org/10.1097/MPG.0b013e31829d4f82. CrossRefPubMed

19.

Haiden N, Ziegler EE. Human Milk Banking. Ann Nutr Metab. 2016;69:8–15. https://doi.org/10.1159/000452821.CrossRefPubMed

20.

Marinković V, Ranković-Janevski M, Spasić S, Nikolić-Kokić A, Lugonja N, Djurović D, et al. Antioxidative activity of colostrum and human Milk: effects of pasteurization and storage. J Pediatr Gastroenterol Nutr. 2016;62:901–6. https://doi.org/10.1097/MPG.0000000000001090.CrossRefPubMed

21.

Committee on nutrition; Section on breastfeeding; Committee on fetus and newborn. Donor human Milk for the high-risk infant: preparation, safety, and usage options in the United States. Pediatrics. 2017;139:1. https://doi.org/10.1542/peds.2016-3440.CrossRef

22.

Maffei D, Schanler RJ. Human milk is the feeding strategy to prevent necrotizing enterocolitis! Semin Perinatol. 2017;41:36–40. https://doi.org/10.1053/j.semperi.2016.09.016.CrossRefPubMed

23.

Agostoni C, Buonocore G, Carnielli VP, De Curtis M, Darmaun D, Decsi T, et al. ESPGHAN committee on nutrition. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, hepatology and nutrition committee on nutrition. J Pediatr Gastroenterol Nutr. 2010;50:85–91. https://doi.org/10.1097/MPG.0b013e3181adaee0. CrossRefPubMed

24.

Choi A, Fusch G, Rochow N, Fusch C. Target fortification of breast Milk: predicting the final osmolality of the feeds. PLoS One. 2016;11:e0148941. https://doi.org/10.1371/journal.pone.0148941.CrossRefPubMedPubMedCentral

25.

de Oliveira SC, Bellanger A, Ménard O, Pladys P, Le Gouar Y, Dirson E, et al. Impact of human milk pasteurization on gastric digestion in preterm infants: a randomized controlled trial. Am J Clin Nutr. 2017;105:379–90. https://doi.org/10.3945/ajcn.116.142539.CrossRefPubMed

26.

Baro C, Giribaldi M, Arslanoglu S, Giuffrida MG, Dellavalle G, Conti A, et al. Effect of two pasteurization methods on the protein content of human milk. Front Biosci. 2011;3:818–29.

27.

Peila C, Emmerik NE, Giribaldi M, Stahl B, Ruitenberg JE, van Elburg RM, et al. Human milk processing: a systematic review of innovative techniques to ensure the safety and quality of donor milk. 2017; 64.353–361. https://doi.org/10.1097/MPG.0000000000001435.

28.

Morlacchi L, Mallardi D, Giannì ML, Roggero P, Amato O, Piemontese P, et al. Is targeted fortification of human breast milk an optimal nutrition strategy for preterm infants? An interventional study. J Transl Med. 2016;14:195. https://doi.org/10.1186/s12967-016-0957-y.CrossRefPubMedPubMedCentral

29.

Rochow N, Fusch G, Choi A, Chessell L, Elliott L, McDonald K, et al. Target fortification of breast milk with fat, protein, and carbohydrates for preterm infants. J Pediatr. 2013;163:1001–7. https://doi.org/10.1016/j.jpeds.2013.04.052. Epub 2013 June 12.CrossRefPubMed

Title: Macronutrient content of pooled donor human milk before and after Holder pasteurization
Authors: Pasqua Piemontese
Domenica Mallardi
Nadia Liotto
Chiara Tabasso
Camilla Menis
Michela Perrone
Paola Roggero
Fabio Mosca
Publication date: 01-12-2019
Publisher: BioMed Central
Published in: BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-019-1427-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Macronutrient content of pooled donor human milk before and after Holder pasteurization

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2019

Sports facilities, socio-economic context and overweight among the childhood population in two southern European cities: a cross sectional study

Comparison of Military Health System Data Repository and American College of Surgeons National Surgical Quality Improvement Program-Pediatric

Short-term outcomes of extremely preterm infants at discharge: a multicenter study from Guangdong province during 2008–2017

Comparing apples and pears: misleading conclusions about the population mental health impact of a parenting programme, a commentary on Marryat, Thompson and Wilson (2017)

Growth of extremely low birth weight infants at a tertiary hospital in a middle-income country

Nutrient intakes and sources of fiber among children with low and high dietary fiber intake: the 2016 feeding infants and toddlers study (FITS), a cross-sectional survey