Discipline of Biochemistry and Molecular Biology, School of Biomedical, Biomolecular, and Chemical Science, The University of Western Australia, Crawley, Western Australia, Australia.
Breastfeed Med. 2010 Apr;5(2):59-66. doi: 10.1089/bfm.2009.0028.
It is necessary to fortify human milk to promote optimal growth of the very preterm infant. However, the addition of non-human milk components to human milk is not ideal because of the risk of feeding intolerance and necrotizing enterocolitis. Human milk products (HMP) are an alternative to commercially available fortifiers, but their preparation is likely to result in modifications to the qualities of human milk.
Ten batches of HMP were prepared with the aim of meeting a desired protein:energy ratio of 3.0 g of protein/100 kcal. Ultrafiltration was used to produce a skim milk concentrate, to which cream was then added to produce the final HMP. Characterization of HMP and human milk fortified with commercial human milk fortifiers (Nutriprem [Cow & Gate, Limerick, Ireland] and S-26 SMA human milk fortifier [Wyeth Nutrition, Baulkham Hills, NSW, Australia]) included quantifying macronutrient content, osmolality, microbial content, and particle distribution.
Average protein:energy ratio of the final batch was 2.93 +/- 0.10 g of protein/100 kcal, equating to an inaccuracy of 2.5% relative to the desired ratio of 3.0 g of protein/100 kcal. Significantly greater fat (P < 0.01), lower lactose (P < 0.001), and lower osmolality (P < 0.001) were characteristic of the HMP compared to human milk fortified with either commercial fortifier. Microbial growth occurred during preparation of HMP but did not exceed 10(5) colony-forming units/mL, and pasteurization of human milk prevented contamination in 80% of batches.
HMP can be designed to accurately target the protein and energy requirements of the preterm infant, but modifications of the macronutrient, biochemical, structural, and microbial characteristics of human milk may affect the quality of the final product.
为促进极早产儿的最佳生长，有必要对人乳进行强化。然而，由于不耐受和坏死性小肠结肠炎的风险，向人乳中添加非人乳成分并不理想。人乳产品（HMP）是市售强化剂的替代品，但它们的制备很可能会改变人乳的质量。
制备了 10 批 HMP，目的是达到理想的蛋白质：能量比 3.0 g 蛋白质/100 kcal。超滤用于生产脱脂奶浓缩物，然后向其中添加奶油以生产最终的 HMP。对 HMP 和用人乳商业强化剂（Nutriprem [Cow & Gate，利默里克，爱尔兰]和 S-26 SMA 人乳强化剂[惠氏营养，Baulkham Hills，新南威尔士州，澳大利亚]）强化的人乳进行了特性描述，包括测定宏量营养素含量、渗透压、微生物含量和颗粒分布。
最终批的平均蛋白质：能量比为 2.93 +/- 0.10 g 蛋白质/100 kcal，与期望的 3.0 g 蛋白质/100 kcal 相比，相对误差为 2.5%。与用人乳商业强化剂强化的人乳相比，HMP 的脂肪含量显著更高（P < 0.01），乳糖含量更低（P < 0.001），渗透压更低（P < 0.001）。在 HMP 的制备过程中发生了微生物生长，但未超过 10(5) 菌落形成单位/mL，人乳的巴氏消毒可防止 80%批次的污染。
HMP 可以设计为准确满足早产儿的蛋白质和能量需求，但人乳的宏量营养素、生化、结构和微生物特性的改变可能会影响最终产品的质量。
