Standard fortification of preterm human milk fails to meet recommended protein intake: Bedside evaluation by Near-Infrared-Reflectance-Analysis

Corvaglia, Luigi; Aceti, Arianna; Paoletti, Vittoria; Mariani, Elisa; Patrono, Daniela; Ancora, Gina; Capretti, Maria Grazia; Faldella, Giacomo

doi:10.1016/j.earlhumdev.2010.04.001

« Previous Next »Early Human Development
Volume 86, Issue 4 , Pages 237-240, April 2010

Standard fortification of preterm human milk fails to meet recommended protein intake: Bedside evaluation by Near-Infrared-Reflectance-Analysis

Luigi Corvaglia
- Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy
- “Centro Interdipartimentale di Ricerca sull'Alimentazione Umana, CIRAU”, University of Bologna, Italy
- Corresponding author. Neonatologia e Terapia Intensiva Neonatale, Policlinico S.Orsola-Malpighi, Via Massarenti 11, 40138 Bologna, Italy. Tel./fax: +39 051 342754.
- These authors contributed equally to the paper.
Arianna Aceti
- Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy
- These authors contributed equally to the paper.
Vittoria Paoletti
- Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy
Elisa Mariani
- Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy
Daniela Patrono
- Central Laboratory, S. Orsola-Malpighi Hospital, Bologna, Italy
Gina Ancora
- Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy
Maria Grazia Capretti
- Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy
Giacomo Faldella
- Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy
- “Centro Interdipartimentale di Ricerca sull'Alimentazione Umana, CIRAU”, University of Bologna, Italy

Received 2 February 2010; received in revised form 26 March 2010; accepted 9 April 2010.

Abstract

Background

Protein content of preterm human milk (HM) is relatively low and extremely variable among mothers: thus, recommended protein intake is rarely met.

Objectives

To evaluate in a NICU setting if HM protein content after standard fortification meets the recommended intake, and also to check the effect of fortification on the osmolality of HM, as an index of feeding intolerance.

Methods

Protein content of 34 preterm HM samples was evaluated by a bedside technique (Near-Infrared-Reflectance-Analysis — NIRA); osmolality was also checked. Seventeen samples were fortified with Aptamil BMF, Milupa (Group A) and 17 with FM85, Nestlé (Group B). Fortification was performed as recommended by the manufacturer (“full fortification [FF]”) and also with a lower amount of fortifier (“low-dose fortification [LF]”). After fortification, actual protein content was calculated and compared to that needed to meet recommended intake (2.33–3g/dl), and osmolality was measured.

Results

After FF, protein content was above 3g/dl in none of the samples, and below 2.33g/dl in 16/34 samples (11 in Group A, 5 in Group B). After LF, protein content was above 3g/dl in none of the samples and below 2.33g/dl in 32/34 samples (15 in Group A, 17 in Group B). Osmolality exceeded 400mOsm/kg in 19 samples after FF (10 in Group A, 9 in Group B) and in 2/34 samples after LF (1 in each group).