S. Orsola-Malpighi Hospital, University of Bologna, Italy.
Early Hum Dev. 2010 Apr;86(4):237-40. doi: 10.1016/j.earlhumdev.2010.04.001. Epub 2010 May 6.
Protein content of preterm human milk (HM) is relatively low and extremely variable among mothers: thus, recommended protein intake is rarely met.
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.
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.
After FF, protein content was above 3g/dl in none of the samples, and below 2.33 g/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 2.33 g/dl in 32/34 samples (15 in Group A, 17 in Group B). Osmolality exceeded 400 mOsm/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).
HM protein content after standard fortification fails to meet the recommended intake for preterm infants in approximately half of the cases.
早产儿母乳（HM）的蛋白质含量相对较低，且在不同母亲间差异极大：因此，推荐的蛋白质摄入量很少能得到满足。
在新生儿重症监护病房（NICU）环境中评估经标准强化后的 HM 蛋白质含量是否能满足推荐摄入量，并检查强化对 HM 渗透压的影响，作为喂养不耐受的指标。
通过床边技术（近红外反射分析-NIRA）评估 34 份早产儿 HM 样本的蛋白质含量；同时检查渗透压。17 份样本用 Aptamil BMF、Milupa（A 组）强化，17 份用 FM85、Nestlé（B 组）强化。强化按照制造商的建议进行（“全强化[FF]”），也使用较少剂量的强化剂（“低剂量强化[LF]”）。强化后，计算实际蛋白质含量并与满足推荐摄入量（2.33-3g/dl）所需的量进行比较，并测量渗透压。
在 FF 后，没有样本的蛋白质含量超过 3g/dl，16/34 样本（A 组 11 个，B 组 5 个）的蛋白质含量低于 2.33g/dl。在 LF 后，没有样本的蛋白质含量超过 3g/dl，34/34 样本（A 组 15 个，B 组 17 个）的蛋白质含量低于 2.33g/dl。在 FF 后，19 个样本的渗透压超过 400 mOsm/kg（A 组 10 个，B 组 9 个），在 LF 后 2/34 样本的渗透压超过 400 mOsm/kg（每组 1 个）。
经标准强化后的 HM 蛋白质含量在大约一半的情况下不能满足早产儿的推荐摄入量。
