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Mazur K, Kusznierewicz B, Martysiak-Żurowska D, Drążkowska I, Malinowska-Pańczyk E. The Effect of Hyperbaric Storage on the Nutritional Value and Retention of Certain Bioactive Proteins in Human Milk. Nutrients 2024; 16:1455. [PMID: 38794693 PMCID: PMC11124269 DOI: 10.3390/nu16101455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Human milk (HM) contains the essential macronutrients and bioactive compounds necessary for the normal growth and development of newborns. The milk collected by human milk banks is stored frozen and pasteurized, reducing its nutritional and biological value. The purpose of this study was to determine the effect of hyperbaric storage at subzero temperatures (HS-ST) on the macronutrients and bioactive proteins in HM. As control samples, HM was stored at the same temperatures under 0.1 MPa. A Miris HM analyzer was used to determine the macronutrients and the energy value. The lactoferrin (LF), lysozyme (LYZ) and α-lactalbumin (α-LAC) content was checked using high-performance liquid chromatography, and an ELISA test was used to quantify secretory immunoglobulin A (sIgA). The results showed that the macronutrient content did not change significantly after 90 days of storage at 60 MPa/-5 °C, 78 MPa/-7 °C, 111 MPa/-10 °C or 130 MPa/-12 °C. Retention higher than 90% of LYZ, α-LAC, LF and sIgA was observed in the HM stored at conditions of up to 111 MPa/-10 °C. However, at 130 MPa/-12 °C, there was a reduction in LYZ and LF, by 39 and 89%, respectively. The storage of HM at subzero temperatures at 0.1 MPa did not affect the content of carbohydrates or crude and true protein. For fat and the energy value, significant decreases were observed at -5 °C after 90 days of storage.
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Affiliation(s)
- Katarzyna Mazur
- Department of Food Chemistry, Technology and Biotechnology, Chemical Faculty, Gdansk University of Technology, G. Narutowicza 11/12 Str., 80-233 Gdańsk, Poland; (K.M.); (B.K.); (D.M.-Ż.)
| | - Barbara Kusznierewicz
- Department of Food Chemistry, Technology and Biotechnology, Chemical Faculty, Gdansk University of Technology, G. Narutowicza 11/12 Str., 80-233 Gdańsk, Poland; (K.M.); (B.K.); (D.M.-Ż.)
| | - Dorota Martysiak-Żurowska
- Department of Food Chemistry, Technology and Biotechnology, Chemical Faculty, Gdansk University of Technology, G. Narutowicza 11/12 Str., 80-233 Gdańsk, Poland; (K.M.); (B.K.); (D.M.-Ż.)
| | - Izabela Drążkowska
- Division of Neonatology, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Edyta Malinowska-Pańczyk
- Department of Food Chemistry, Technology and Biotechnology, Chemical Faculty, Gdansk University of Technology, G. Narutowicza 11/12 Str., 80-233 Gdańsk, Poland; (K.M.); (B.K.); (D.M.-Ż.)
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Zhang Z, Wang Y, Yang X, Cheng Y, Zhang H, Xu X, Zhou J, Chen H, Su M, Yang Y, Su Y. Human Milk Lipid Profiles around the World: A Systematic Review and Meta-Analysis. Adv Nutr 2022; 13:2519-2536. [PMID: 36083999 PMCID: PMC9776668 DOI: 10.1093/advances/nmac097] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/08/2022] [Accepted: 09/01/2022] [Indexed: 01/29/2023] Open
Abstract
Reported breast milk lipid concentrations may vary with geographical region, postnatal age, and year of sample collection. In this review, we summarized data on the concentrations of total fat, total phospholipids, cholesterol, and fatty acids in human milk worldwide and their variation according to lactation stage, study area, and sample collection year. A systematic literature search was performed using the PubMed, Embase, Web of Science, and Medline databases for English-language papers and Wanfang and China National Knowledge Infrastructure databases for Chinese-language papers. A total of 186 studies evaluating the human milk lipid profiles were included. According to random-effects models based on worldwide data, the summarized means (95% CIs) as percentages of total fat were 42.2% (41.1%, 43.3%) for SFAs, 36.6% (35.6%, 37.5%) for MUFAs, and 21.0% (19.3%, 22.7%) for PUFAs. However, the study heterogeneity was high for most types of fatty acids (I2 > 99%). Human milk from Western countries had higher concentrations of MUFAs and 18:1n-9 (ω-9), but lower concentrations of PUFAs, 18:2n-6, 20:4n-6, 18:3n-3, 20:5n-3, 22:6n-3, and total n-6 PUFA compared with those from non-Western countries (P < 0.001-0.011). Significant lactation stage differences were observed for total fat and some individual fatty acids. The concentrations of SFAs and 16:0 were significantly negatively correlated with sampling year (P < 0.001-0.028). In contrast, a significant positive correlation between the concentrations of 18:2n-6 and 18:3n-3 and sampling year was observed (P < 0.001-0.035). Our results suggest that the pooling of data on human milk lipid profiles in different studies should be done with caution due to the high between-study heterogeneity. The concentration of lipids, including total fat, cholesterol, and specific fatty acids, differs in human milk according to lactation stage, geographical region, and year of sample collection.
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Affiliation(s)
- Zheqing Zhang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yingyao Wang
- Chinese Nutrition Society, Beijing, China,CNS Academy of Nutrition and Health (Beijing Zhongyinghui Nutrition and Health Research Institute), Beijing, China
| | - Xiaoguang Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yiyong Cheng
- Institute of Health & Environmental Medicine, Tianjin, China
| | - Hong Zhang
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Xuebing Xu
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Jin Zhou
- CNS Academy of Nutrition and Health (Beijing Zhongyinghui Nutrition and Health Research Institute), Beijing, China
| | - Hengying Chen
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Mengyang Su
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
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Ruan H, Tang Q, Zhang Y, Zhao X, Xiang Y, Feng Y, Cai W. Comparing human milk macronutrients measured using analyzers based on mid-infrared spectroscopy and ultrasound and the application of machine learning in data fitting. BMC Pregnancy Childbirth 2022; 22:562. [PMID: 35836199 PMCID: PMC9284806 DOI: 10.1186/s12884-022-04891-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 07/01/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Fat, carbohydrates (mainly lactose) and protein in breast milk all provide indispensable benefits for the growth of newborns. The only source of nutrition in early infancy is breast milk, so the energy of breast milk is also crucial to the growth of infants. Some macronutrients composition in human breast milk varies greatly, which could affect its nutritional fulfillment to preterm infant needs. Therefore, rapid analysis of macronutrients (including lactose, fat and protein) and milk energy in breast milk is of clinical importance. This study compared the macronutrients results of a mid-infrared (MIR) analyzer and an ultrasound-based breast milk analyzer and unified the results by machine learning. METHODS This cross-sectional study included breastfeeding mothers aged 22-40 enrolled between November 2019 and February 2021. Breast milk samples (n = 546) were collected from 244 mothers (from Day 1 to Day 1086 postpartum). A MIR milk analyzer (BETTERREN Co., HMIR-05, SH, CHINA) and an ultrasonic milk analyzer (Honɡyanɡ Co,. HMA 3000, Hebei, CHINA) were used to determine the human milk macronutrient composition. A total of 465 samples completed the tests in both analyzers. The results of the ultrasonic method were mathematically converted using machine learning, while the Bland-Altman method was used to determine the limits of agreement (LOA) between the adjusted results of the ultrasonic method and MIR results. RESULTS The MIR and ultrasonic milk analyzer results were significantly different. The protein, fat, and energy determined using the MIR method were higher than those determined by the ultrasonic method, while lactose determined by the MIR method were lower (all p < 0.05). The consistency between the measured MIR and the adjusted ultrasound values was evaluated using the Bland-Altman analysis and the scatter diagram was generated to calculate the 95% LOA. After adjustments, 93.96% protein points (436 out of 465), 94.41% fat points (439 out of 465), 95.91% lactose points (446 out of 465) and 94.62% energy points (440 out of 465) were within the LOA range. The 95% LOA of protein, fat, lactose and energy were - 0.6 to 0.6 g/dl, -0.92 to 0.92 g/dl, -0.88 to 0.88 g/dl and - 40.2 to 40.4 kj/dl, respectively and clinically acceptable. The adjusted ultrasonic results were consistent with the MIR results, and LOA results were high (close to 95%). CONCLUSIONS While the results of the breast milk rapid analyzers using the two methods varied significantly, they could still be considered comparable after data adjustments using linear regression algorithm in machine learning. Machine learning methods can play a role in data fitting using different analyzers.
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Affiliation(s)
- Huijuan Ruan
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qingya Tang
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yajie Zhang
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.,Shanghai Institute of Pediatric Research, Shanghai, China
| | - Xuelin Zhao
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Xiang
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Feng
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Cai
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. .,Shanghai Institute of Pediatric Research, Shanghai, China. .,Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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He G, Li G, Jiang Y, Hua J, Chu X, Xiong L, Gong J, Xiao G, Ye X. Macronutrient content and fatty acid composition and their positional distribution in human breast milk from Zhejiang Province, China in different lactation periods. Food Sci Nutr 2021; 9:6746-6761. [PMID: 34925804 PMCID: PMC8645764 DOI: 10.1002/fsn3.2626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 12/30/2022] Open
Abstract
Lactational changes in macronutrient content, lipid profile, fatty acid composition, and positional distribution of human breast milk were investigated in this study. A total of 378 milk samples of six different lactation periods, including 0‒5, 6‒14, 15‒30, 31‒90, 91‒180, and 181‒360 days, were collected cross-sectionally from healthy lactating women in Zhejiang, China. As lactation progressed from 0‒5 to 15‒30 days, the lipid content and the percentages of C10:0, C12:0, C14:0, C18:2n-6, and C18:3n-3 increased significantly, while the protein concentration and the proportions of phospholipids, cholesterols, C16:0, C18:1n-9, C24:1n-9, C20:4n-6, C22:4n-6, C22:5n-3, and C22:6n-3 decreased notably. When lactation was further extended to 181‒360 days, the protein content continued to decrease, and the percentages of C12:0 and C14:0 continued to increase, whereas the levels of other tested nutrients remained stable. Although the triacylglycerol positional distributions of some fatty acids underwent significant lactational variations, C14:0, C16:0, C24:1n-9, C22:4n-6, C22:5n-3, and C22:6n-3 were located mainly at the sn-2 position, while C18:1n-9, C18:2n-6, and C18:3n-3 were primarily distributed at the sn-1,3 positions. Compared with human breast milk reported in Western countries, samples in our study demonstrated higher percentages of C18:2n-6, C18:3n-3, C20:4n-6, and C22:6n-3, but lower proportions of C12:0, C14:0, and C18:1n-9. The results from this study indicated a nutritional composition different from that of the Western countries and may provide useful data for the development of infant formulas closer to Chinese breast milk in terms of the fatty acid composition and its specified positional distribution on triglyceride structure.
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Affiliation(s)
- Guanghua He
- Department of Food Science and NutritionZhejiang UniversityHangzhouChina
- School of Biological and Chemical EngineeringZhejiang University of Science and TechnologyHangzhouChina
| | - Guipu Li
- Beingmate (Hangzhou) Food Research Institute Co., LtdHangzhouChina
| | - Yanxi Jiang
- Beingmate (Hangzhou) Food Research Institute Co., LtdHangzhouChina
| | - Jiacai Hua
- Beingmate (Hangzhou) Food Research Institute Co., LtdHangzhouChina
| | - Xiaojun Chu
- Beingmate (Hangzhou) Food Research Institute Co., LtdHangzhouChina
| | - Lina Xiong
- Beingmate (Hangzhou) Food Research Institute Co., LtdHangzhouChina
| | - Jinyan Gong
- School of Biological and Chemical EngineeringZhejiang University of Science and TechnologyHangzhouChina
| | - Gongnian Xiao
- School of Biological and Chemical EngineeringZhejiang University of Science and TechnologyHangzhouChina
| | - Xingqian Ye
- Department of Food Science and NutritionZhejiang UniversityHangzhouChina
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Using Nature to Nurture: Breast Milk Analysis and Fortification to Improve Growth and Neurodevelopmental Outcomes in Preterm Infants. Nutrients 2021; 13:nu13124307. [PMID: 34959859 PMCID: PMC8704746 DOI: 10.3390/nu13124307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 12/29/2022] Open
Abstract
Premature infants are born prior to a critical window of rapid placental nutrient transfer and fetal growth-particularly brain development-that occurs during the third trimester of pregnancy. Subsequently, a large proportion of preterm neonates experience extrauterine growth failure and associated neurodevelopmental impairments. Human milk (maternal or donor breast milk) is the recommended source of enteral nutrition for preterm infants, but requires additional fortification of macronutrient, micronutrient, and energy content to meet the nutritional demands of the preterm infant in attempts at replicating in utero nutrient accretion and growth rates. Traditional standardized fortification practices that add a fixed amount of multicomponent fortifier based on assumed breast milk composition do not take into account the considerable variations in breast milk content or individual neonatal metabolism. Emerging methods of individualized fortification-including targeted and adjusted fortification-show promise in improving postnatal growth and neurodevelopmental outcomes in preterm infants.
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Ramey SR, Merlino Barr S, Moore KA, Groh-Wargo S. Exploring Innovations in Human Milk Analysis in the Neonatal Intensive Care Unit: A Survey of the United States. Front Nutr 2021; 8:692600. [PMID: 34540876 PMCID: PMC8446443 DOI: 10.3389/fnut.2021.692600] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/30/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Human milk (HM) is the ideal enteral feeding for nearly all infants and offers unique benefits to the very low birthweight (VLBW) infant population. It is a challenge to meet the high nutrient requirements of VLBW infants due to the known variability of HM composition. Human milk analysis (HMA) assesses the composition of HM and allows for individualized fortification. Due to recent U.S. Food and Drug Administration (FDA) approval, it has relatively recent availability for clinical use in the US. Aim: To identify current practices of HMA and individualized fortification in neonatal intensive care units (NICUs) across the United States (US) and to inform future translational research efforts implementing this nutrition management method. Methods: An institutional review board (IRB) approved survey was created and collected data on the following subjects such as NICU demographics, feeding practices, HM usage, HM fortification practices, and HMA practices. It was distributed from 10/30–12/21/2020 via online pediatric nutrition groups and listservs selected to reach the intended audience of NICU dietitians and other clinical staff. Each response was assessed prior to inclusion, and descriptive analysis was performed. Results: About 225 survey responses were recorded during the survey period with 119 entries included in the analysis. This represented 36 states and Washington D.C., primarily from level III and IV NICUs. HMA was reported in 11.8% of responding NICUs. The most commonly owned technology for HMA is the Creamatocrit Plus TM (EKF Diagnostics), followed by the HM Analyzer by Miris (Uppsala, Sweden). In NICUs practicing HMA, 84.6% are doing so clinically. Discussion: Feeding guidelines and fortification of HM remain standard of care, and interest in HMA was common in this survey. Despite the interest, very few NICUs are performing HMA and individualized fortification. Barriers identified include determining who should receive individualized fortification and how often, collecting a representative sample, and the cost and personnel required. Conclusions: Human milk analysis and individualized fortification are emerging practices within NICUs in the US. Few are using it in the clinical setting with large variation in execution among respondents and many logistical concerns regarding implementation. Future research may be beneficial to evaluate how practices change as HMA and individualized fortification gain popularity and become more commonly used in the clinical setting.
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Affiliation(s)
- Stacey R Ramey
- MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
| | - Stephanie Merlino Barr
- MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
| | - Katie A Moore
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Sharon Groh-Wargo
- MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
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Zhang X, Zhang M, Lin T, Zhao J, Luo Z, Hou J, Sun B, Chen L. Relationship between traditional maternal diet pattern and breastmilk composition of rural lactating women during the first month postpartum in Shigatse, Tibet. Food Sci Nutr 2021; 9:4185-4198. [PMID: 34401070 PMCID: PMC8358384 DOI: 10.1002/fsn3.2384] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 11/10/2022] Open
Abstract
Maternal nutrition can influence the composition of human breastmilk by altering the components that are sensitive to maternal diet pattern. Traditional Tibetan maternal diet pattern among native rural lactating women possesses distinct characteristics due to its unique geographical environment and dietary habits. This study investigated maternal diet pattern and human breastmilk composition of Tibetan lactating women through different lactation stages during the first month postpartum in Shigatse. The results indicated that Tibetan maternal diet profile was apparently monotonous, mainly sufficient in Zanba, buttered tea, red meat, and fatty soup, yet insufficient in white meat, eggs, leafy vegetables, and fruits, leading to imperfect maternal nutritional intakes with high-level carbohydrates and deficient proteins. Distinctions of maternal diet profiles in various degrees can be discovered upon different lactation stages, which brings multiple influences to the composition of human milk. There was significantly weak-to-medium correlation of protein contents between maternal diet intakes and human milk, while other macronutrients correlated insignificantly. Micronutrient constituents in human milk, involving functional unsaturated fatty acids and free essential amino acids, were also impacted by maternal diet intakes through different lactation stages. These results show that more systematic and profound research is requisite for the clarification and development of Tibetan maternal diet to offer more enhanced and individualized nutritional recommendations for Tibetan lactating women and infants.
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Affiliation(s)
- Xiaomei Zhang
- National Engineering Center of Dairy for Maternal and Child HealthBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Engineering Research Center of DairyBeijing Technical Innovation Center of Human Milk ResearchBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Advanced Innovation Center for Food Nutrition and Human HealthBeijing Technology & Business UniversityBeijingChina
| | - Minghui Zhang
- National Engineering Center of Dairy for Maternal and Child HealthBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Engineering Research Center of DairyBeijing Technical Innovation Center of Human Milk ResearchBeijing Sanyuan Foods Co. Ltd.BeijingChina
| | - Tie Lin
- National Engineering Center of Dairy for Maternal and Child HealthBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Engineering Research Center of DairyBeijing Technical Innovation Center of Human Milk ResearchBeijing Sanyuan Foods Co. Ltd.BeijingChina
| | - Junying Zhao
- National Engineering Center of Dairy for Maternal and Child HealthBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Engineering Research Center of DairyBeijing Technical Innovation Center of Human Milk ResearchBeijing Sanyuan Foods Co. Ltd.BeijingChina
| | - Zhang Luo
- Food Science CollegeTibet Agriculture & Animal Husbandry UniversityNyingchi, TibetChina
| | - Juncai Hou
- Key Laboratory of Dairy Science, Ministry of EducationCollege of Food ScienceNortheast Agricultural UniversityHarbinChina
| | - Baoguo Sun
- Beijing Advanced Innovation Center for Food Nutrition and Human HealthBeijing Technology & Business UniversityBeijingChina
| | - Lijun Chen
- National Engineering Center of Dairy for Maternal and Child HealthBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Engineering Research Center of DairyBeijing Technical Innovation Center of Human Milk ResearchBeijing Sanyuan Foods Co. Ltd.BeijingChina
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Quinn EA. Centering human milk composition as normal human biological variation. Am J Hum Biol 2021; 33:e23564. [DOI: 10.1002/ajhb.23564] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/25/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Elizabeth A. Quinn
- Department of Anthropology Washington University in St. Louis Saint Louis Missouri USA
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Borràs-Novell C, Herranz Barbero A, Aldecoa-Bilbao V, Feixas Orellana G, Balcells Esponera C, Sánchez Ortiz E, García-Algar O, Iglesias Platas I. Infrared analyzers for the measurement of breastmilk macronutrient content in the clinical setting. Expert Rev Mol Diagn 2020; 20:867-887. [PMID: 32876510 DOI: 10.1080/14737159.2020.1816465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION There is growing interest in the possibility of measuring the macronutrient content of human milk. Several studies that intend to validate commercially available human milk analyzers have been published with inconsistent results. This review will focus on currently available, verified methodologies for analyzing macronutrients in human milk. AREAS COVERED A literature search was conducted in the PubMed database. Five milk analyzers were chosen to be included in this review: MIRIS (Uppsala, Sweden) (seven articles found), Calais (Cleveland, United States) (four articles), SpectraStar (Brookfield, United States) (four articles), MilkoScan (Hillerdo, Denmark) (two articles), and Delta LactoScope (Stockholm, Sweden) (one article). The following information was extracted from published manuscripts: measuring device, sample preparation, purpose of the study, type of macronutrients studied, results, and conclusions. EXPERT OPINION Infrared spectroscopy can be an accurate and reliable technology for assessing the macronutrient content of human milk, specifically crude protein, and total fat. However, an optimal handling of samples, the development of standardized quality-control protocols, and an improvement in calibration procedures are required before the full implementation of infrared technology in neonatal units.
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Affiliation(s)
- Cristina Borràs-Novell
- Neonatology Department. BCNatal - Centre De Medicina Maternofetal I Neonatologia De Barcelona, Hospital Clínic, Universitat De Barcelona , Barcelona, Spain
| | - Ana Herranz Barbero
- Neonatology Department. BCNatal - Centre De Medicina Maternofetal I Neonatologia De Barcelona, Hospital Clínic, Universitat De Barcelona , Barcelona, Spain
| | - Victoria Aldecoa-Bilbao
- Neonatology Department. BCNatal - Centre De Medicina Maternofetal I Neonatologia De Barcelona, Hospital Clínic, Universitat De Barcelona , Barcelona, Spain
| | - Georgina Feixas Orellana
- Neonatology Department. BCNatal - Centre De Medicina Maternofetal I Neonatologia De Barcelona, Hospital Clínic, Universitat De Barcelona , Barcelona, Spain
| | - Carla Balcells Esponera
- Neonatology Department. BCNatal - Centre De Medicina Maternofetal I Neonatologia De Barcelona, Hospital Sant Joan De Déu, Universitat De Barcelona , Barcelona, Spain
| | - Erika Sánchez Ortiz
- Neonatology Department. BCNatal - Centre De Medicina Maternofetal I Neonatologia De Barcelona, Hospital Clínic, Universitat De Barcelona , Barcelona, Spain
| | - Oscar García-Algar
- Neonatology Department. BCNatal - Centre De Medicina Maternofetal I Neonatologia De Barcelona, Hospital Clínic, Universitat De Barcelona , Barcelona, Spain
| | - Isabel Iglesias Platas
- Neonatology Department. BCNatal - Centre De Medicina Maternofetal I Neonatologia De Barcelona, Hospital Sant Joan De Déu, Universitat De Barcelona , Barcelona, Spain
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Paulaviciene IJ, Liubsys A, Molyte A, Eidukaite A, Usonis V. Circadian changes in the composition of human milk macronutrients depending on pregnancy duration: a cross-sectional study. Int Breastfeed J 2020; 15:49. [PMID: 32450886 PMCID: PMC7249354 DOI: 10.1186/s13006-020-00291-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 05/11/2020] [Indexed: 12/31/2022] Open
Abstract
Background The purpose of this study was to evaluate the circadian variation of human milk macronutrients and energy content depending upon pregnancy duration. Methods One hundred eighty fresh human milk samples from 45 mothers (27 of preterm and 18 of full-term newborns) were collected on a single day chosen between the 14th to 16th day after delivery. The samples were taken four times per day at 12 PM, 6 PM, 12 AM and 6 AM. Only lactating women, who could not breastfeed their hospitalized newborns and expressed milk by breast pump, were enrolled in the study. Human milk macronutrient composition and energy count were evaluated by mid-infrared spectrophotometry. Results Significant differences in macronutrient content were observed between 6 AM and 12 PM for mean protein content (t = − 4.62, df = 44, p < 0.001), for mean fat content (t = − 2.10, df = 44, p = 0.04) and for mean energy content (t = − 2.24, df = 44, p = 0.03); between 6 AM and 6 PM for mean protein content (t = − 2.41, df = 43, p = 0.02), for mean fat content (t = − 3.76, df = 43, p = 0.001) and for mean energy content (t = − 3.85, df = 43, p < 0.001); between 12 PM and 12 AM for mean protein content (Wilcoxon test V = 75.5, p = 0.001), for mean fat content (t = 2.50, df = 44, p = 0.02) and for mean energy content (t = 2.74, df = 44, p = 0.01); between 6 PM and 12 AM for mean protein content (V = 229, p = 0.02), for mean fat content (t = 4.39, df = 43, p < 0.001) and for mean energy content (t = − 4.57, df = 43, p < 0.001). The average content of carbohydrates did not change significantly during the 24 h. The samples of preterm newborns’ mothers had more apparent diurnal fluctuations in macronutrient content. Conclusions Our study revealed significant diurnal variations in protein and fat in human milk, and these circadian fluctuations were more apparent in the milk of mothers of preterm infants.
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Affiliation(s)
- Ieva Jura Paulaviciene
- Clinic of Children Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. .,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
| | - Arunas Liubsys
- Clinic of Children Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Alma Molyte
- Department of Human and Medical Genetics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Department of Information Systems, Faculty of Fundamental Sciences, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Audrone Eidukaite
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,State Research Institute, Center of Innovative Medicine, Department of Immunology, Vilnius, Lithuania
| | - Vytautas Usonis
- Clinic of Children Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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11
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Perrin MT, Festival J, Starks S, Mondeaux L, Brownell EA, Vickers A. Accuracy and Reliability of Infrared Analyzers for Measuring Human Milk Macronutrients in a Milk Bank Setting. Curr Dev Nutr 2019; 3:nzz116. [PMID: 31723725 PMCID: PMC6838652 DOI: 10.1093/cdn/nzz116] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/09/2019] [Accepted: 10/16/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Infrared (IR) analysis is an emerging technology that may be a useful tool for milk banks to manage the nutrient variability in donor human milk. OBJECTIVE To evaluate the accuracy, reliability, and comparability of commercial infrared analyzers for measuring human milk macronutrients in a milk bank setting. METHODS Three nonprofit milk banks received blinded test kits of human milk that had been assessed using reference methods. Four infrared instruments were used to measure macronutrients as follows: 1 filtered mid-IR, 2 Fourier-transformed full-spectra mid-IR, and 1 near-IR. Twenty-five unique samples were read concurrently for the accuracy arm. An identical sample was read daily for 1 mo for the reliability arm. RESULTS Values for R 2 describing relationships with reference methods for total fat, crude protein, and lactose, were as follows: filtered mid-IR, 0.98, 0.94, and 0.48; Fourier-transformed full-spectra mid-IR, 0.97, 0.93, and 0.36 for instrument 1 and 0.98, 0.98, and 0.31 for instrument 2; and near-IR 0.93, 0.93, and 0.12. There was no significant difference between instruments for crude protein and total fat measurements. There were significant differences in carbohydrate measurements between instruments. For 1 mo of daily measurements in the reliability arm, CVs for filtered mid-IR were ≤4.6%, for Fourier-transformed full spectra mid-IR were ≤1.7%, and for near-IR were ≤5.1%. CONCLUSIONS Infrared analysis is an accurate and reliable method for measuring crude protein and total fat in a milk bank setting. Carbohydrate measurements are less accurate and are significantly different between instruments, which will likely lead to differences in derived calorie values.
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Affiliation(s)
- Maryanne T Perrin
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, USA
| | | | - Shaina Starks
- Mothers' Milk Bank of North Texas, Fort Worth, TX, USA
| | | | - Elizabeth A Brownell
- Connecticut Children's Medical Center, Hartford CT, USA
- University of Connecticut School of Medicine, Farmington, CT, USA
| | - Amy Vickers
- Mothers' Milk Bank of North Texas, Fort Worth, TX, USA
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12
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Nessel I, Khashu M, Dyall SC. The effects of storage conditions on long-chain polyunsaturated fatty acids, lipid mediators, and antioxidants in donor human milk - A review. Prostaglandins Leukot Essent Fatty Acids 2019; 149:8-17. [PMID: 31421526 DOI: 10.1016/j.plefa.2019.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/14/2019] [Accepted: 07/12/2019] [Indexed: 12/31/2022]
Abstract
Donor human milk (DHM) is the recommended alternative, if maternal milk is unavailable. However, current human milk banking practices may negatively affect the nutritional quality of DHM. This review summarises the effects of these practices on polyunsaturated fatty acids, lipid mediators and antioxidants of human milk. Overall, there is considerable variation in the reported effects, and further research is needed, particularly with lipid mediators and antioxidants. However, to preserve nutritional quality, DHM should be protected from light exposure and storage at 4 °C minimised, to prevent decreases in vitamin C and endocannabinoids and increases in free fatty acids and lipid peroxidation products. Storage at -20 °C prior to pasteurisation should also be minimised, to prevent free fatty increases and total fat and endocannabinoid decreases. Storage ≤-70 °C is preferable wherever possible, although post-pasteurisation storage at -20 °C for three months appears safe for free fatty acids, lipid peroxidation products, and total fat content.
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Affiliation(s)
- Isabell Nessel
- Centre for Midwifery, Maternal and Perinatal Health, Bournemouth University, Royal London House, Christchurch Road, Bournemouth, BH13LT U.K..
| | - Minesh Khashu
- Centre for Midwifery, Maternal and Perinatal Health, Bournemouth University, Royal London House, Christchurch Road, Bournemouth, BH13LT U.K.; Neonatal Unit, Poole Hospital NHS Foundation Trust, Poole, U.K
| | - Simon C Dyall
- Department of Life Sciences, University of Roehampton, London, U.K
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13
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Comparison of macronutrient content in human milk measured by mid-infrared human milk analyzer and reference methods. J Perinatol 2019; 39:497-503. [PMID: 30552375 PMCID: PMC6514977 DOI: 10.1038/s41372-018-0291-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/21/2018] [Accepted: 11/27/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The study aims at evaluating mid-infrared human milk analyzer (HMA) accuracy and precision, in human milk (HM). STUDY DESIGN Röse-Gottlieb, high-performance anion exchange chromatography-pulsed amperometric detection (HPAEC-PAD), Kjeldahl and amino acid analysis (AA) were selected as references for total fat, lactose and total protein determination. RESULTS No significant difference was observed in lactose content between HMA and HPAEC-PAD. Significant differences were observed in fat and protein content between HMA and reference methods. However, the difference in fat content was lower than 12%, and therefore within the variability declared by supplier. For protein determination, the BCA protein assay was selected. No significant differences were observed in total protein content measured by BCA assay, Kjeldahl and AA methods. CONCLUSIONS HMA was reliable for the quantification of total fat and lactose content, but not for total protein one. The latter was measured by BCA assay, which yielded comparable results to Kjeldahl and AA methods.
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14
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Elsohaby I, McClure JT, Riley CB, Bryanton J, Bigsby K, Shaw RA. Transmission infrared spectroscopy for rapid quantification of fat, protein, and lactose concentrations in human milk. J Perinatol 2018; 38:1685-1693. [PMID: 30275544 DOI: 10.1038/s41372-018-0233-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/16/2018] [Accepted: 09/17/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To develop partial least squares regression (PLSR) calibration models in combination with transmission infrared (TIR) spectroscopy for rapid and optimal quantification of human milk macronutrient concentrations. STUDY DESIGN Human milk samples (n = 306) were characterized simultaneously by reference chemical analytical methods and TIR spectroscopy. Reference macronutrient concentrations were linked to pre-processed spectra and divided into two (training and test) sets. PLSR was used to develop trial calibration models using training set, and the test set was used to assess the accuracy of the trial analytical methods. RESULTS For the methods selected as optimal, the concordance correlation coefficients between reference and TIR-based methods were 0.93 for fat, 0.96 for protein, and 0.52 for lactose. The Bland-Altman plots showed no evidence of systematic bias between TIR and reference methods. CONCLUSIONS TIR spectroscopy provides the basis for accurate and rapid quantification of human milk fat and protein concentrations but is less accurate for measuring lactose concentration.
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Affiliation(s)
- Ibrahim Elsohaby
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada. .,Faculty of Veterinary Medicine, Division of Infectious Diseases, Department of Animal Medicine, Zagazig University, Zagazig City, Sharkia Province, Egypt.
| | - J Trenton McClure
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Christopher B Riley
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada.,School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Janet Bryanton
- Faculty of Nursing, University of Prince Edward Island, Charlottetown, PE, Canada
| | | | - R Anthony Shaw
- National Research Council of Canada, Medical Devices Research Center, Winnipeg, MB, Canada
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15
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Wu X, Jackson RT, Khan SA, Ahuja J, Pehrsson PR. Human Milk Nutrient Composition in the United States: Current Knowledge, Challenges, and Research Needs. Curr Dev Nutr 2018; 2:nzy025. [PMID: 30087951 PMCID: PMC6063275 DOI: 10.1093/cdn/nzy025] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 05/04/2018] [Accepted: 05/29/2018] [Indexed: 12/31/2022] Open
Abstract
Human milk is considered to be the ideal food for infants. Accurate, representative, and up-to-date nutrient composition data of human milk are crucial for the management of infant feeding, assessment of infant and maternal nutritional needs, and as a guide for developing infant formula. Currently in the United States, the nutrient profiles of human milk can be found in the USDA National Nutrient Database for Standard Reference, and in books or review articles. Nonetheless, these resources all suffer major drawbacks, such as being outdated, incomplete profiles, limited sources of data, and uncertain data quality. Furthermore, no nutrient profile was developed specifically for the US population. The purposes of this review were to summarize the current knowledge of human milk nutrient composition from studies conducted in the United States and Canada, and to identify the knowledge gaps and research needs. The literature review was conducted to cover the years 1980-2017, and 28 research papers were found containing original data on macronutrients and micronutrients. Most of these 28 studies were published before 1990 and mainly examined samples from small groups of generally healthy lactating women. The experimental designs, including sampling, storage, and analytic methods, varied substantially between the different studies. Data of several components from these 28 studies showed some consistency for 1-6 mo postpartum, especially for protein, fat, lactose, energy, and certain minerals (e.g., calcium). The data for 7-12 mo postpartum and for other nutrients are very scarce. Comprehensive studies are required to provide current and complete nutrient information on human milk in the United States.
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Affiliation(s)
- Xianli Wu
- Nutrient Data Laboratory, USDA ARS Beltsville Human Nutrition Research Center, Beltsville, MD
| | - Robert T Jackson
- Department of Nutrition and Food Science, University of Maryland, College Park, MD
| | - Saira A Khan
- Department of Nutrition and Food Science, University of Maryland, College Park, MD
| | - Jaspreet Ahuja
- Nutrient Data Laboratory, USDA ARS Beltsville Human Nutrition Research Center, Beltsville, MD
| | - Pamela R Pehrsson
- Nutrient Data Laboratory, USDA ARS Beltsville Human Nutrition Research Center, Beltsville, MD
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16
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Zhu M, Yang Z, Ren Y, Duan Y, Gao H, Liu B, Ye W, Wang J, Yin S. Comparison of macronutrient contents in human milk measured using mid-infrared human milk analyser in a field study vs. chemical reference methods. MATERNAL & CHILD NUTRITION 2017; 13: 10.1111/mcn.12248. [PMID: 26914990 PMCID: PMC6866206 DOI: 10.1111/mcn.12248] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 09/08/2015] [Accepted: 10/27/2015] [Indexed: 11/29/2022]
Abstract
Macronutrient contents in human milk are the common basis for estimating these nutrient requirements for both infants and lactating women. A mid-infrared human milk analyser (HMA, Miris, Sweden) was recently developed for determining macronutrient levels. The purpose of the study is to compare the accuracy and precision of HMA method with fresh milk samples in the field studies with chemical methods with frozen samples in the lab. Full breast milk was collected using electric pumps and fresh milk was analyzed in the field studies using HMA. All human milk samples were thawed and analyzed with chemical reference methods in the lab. The protein, fat and total solid levels were significantly correlated between the two methods and the correlation coefficient was 0.88, 0.93 and 0.78, respectively (p < 0.001). The mean protein content was significantly lower and the mean fat level was significantly greater when measured using HMA method (1.0 g 100 mL-1 vs 1.2 g 100 mL-1 and 3. 7 g 100 mL-1 vs 3.2 g 100 mL-1 , respectively, p < 0.001). Thus, linear recalibration could be used to improve mean estimation for both protein and fat. There was no significant correlation for lactose between the two methods (p > 0.05). There was no statistically significant difference in the mean total solid concentration (12.2 g 100 mL-1 vs 12.3 g 100 mL-1 , p > 0.05). Overall, HMA might be used to analyze macronutrients in fresh human milk with acceptable accuracy and precision after recalibrating fat and protein levels of field samples.
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Affiliation(s)
- Mei Zhu
- Key Laboratory of Trace Element Nutrition, Ministry of Health of China, National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Zhenyu Yang
- Key Laboratory of Trace Element Nutrition, Ministry of Health of China, National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Yiping Ren
- Zhejiang Center for Disease Control and PreventionHangzhou cityZhejiang ProvinceChina
| | - Yifan Duan
- Key Laboratory of Trace Element Nutrition, Ministry of Health of China, National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Huiyu Gao
- Key Laboratory of Trace Element Nutrition, Ministry of Health of China, National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Biao Liu
- Milk Powder Business UnitInner Mongolia YiLi Industrial Group Co. LtdHohhotChina
| | - Wenhui Ye
- Milk Powder Business UnitInner Mongolia YiLi Industrial Group Co. LtdHohhotChina
| | - Jie Wang
- Key Laboratory of Trace Element Nutrition, Ministry of Health of China, National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Shian Yin
- Key Laboratory of Trace Element Nutrition, Ministry of Health of China, National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
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