Osmolality of a fortified human preterm milk: The effect of fortifier dosage, gestational age, lactation stage, and hospital practices
2018
Abstract Objective The purpose of this study was to evaluate the dose-dependent effect of human milk fortifier (HMF) on the
osmolalityof various preterm human milks (PHMs) at different gestational and lactation stages, and with different storage and treatment conditions that are routinely used in neonatal intensive care units (NICUs). Study design Twenty-four mothers who had given birth to their baby before 28 or between 29 and 31 weeks of pregnancy participated in the study after 1–2 weeks or 3–4 weeks breastfeeding after delivery. The study was a prospective, multicenter, comparative, and noninterventional study.
Osmolalityof fresh or
pasteurizedhuman milk stored at 4 °C was measured (cryoscopy) at baseline, and 24 hours after adding Suppletine ® Human Milk fortifier (SHMF) at 3%, 4%, 4.5%, and 5% (w/v). Results PHM without supplementation had an
osmolality(mean ± SD) of 301 ± 8 mOsm/kgH 2 O ( n = 40; 95% CI: [298; 303]). Adding 3–5% SHMF induced a linear increase of
osmolality( P r 2 = 0.975). With 4% SHMF, the
osmolalitymeasure was 443 ± 13 mOsm/kg H 2 O (95% CI: [439–447]). Neither a 24-hour storage at 4 °C nor
pasteurizationinduced a modification of
osmolalitycompared to the fresh samples. Conclusion Whatever the origin and quality of milk as well as hospital practices, adding up to 4% (w/v) SHMF to PHM increases its nutritional quality and
osmolalitywithout exceeding 450 mOsm/kgH 2 O, which is
generally recognizedas
safe.
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