Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, United States of America.
Maternal, Newborn, Child Health and Nutrition, PATH, Seattle, WA, United States of America.
PLoS One. 2023 Apr 5;18(4):e0283846. doi: 10.1371/journal.pone.0283846. eCollection 2023.
Globally, almost 15 million infants are born prematurely each year, disproportionately affecting low and middle-income countries. In the absence of mother's milk, the World Health Organization recommends using donor human milk (DHM) due to its protective effect against necrotizing enterocolitis, a life-threatening intestinal disorder. The use of DHM is increasing globally, with many low and middle-income countries integrating donor milk banks into their public health strategies to reduce neonatal mortality, yet very little is known about the nutritional composition of DHM. Additional knowledge gaps include how DHM composition is influenced by milk banking practices, and whether preterm nutrient recommendations are achieved when DHM is used with commercially available fortifiers.
We designed a multi-site study with eight geographically diverse milk bank partners in high, middle, and low-income settings that will examine and compare a broad range of nutrients and bioactive factors in human milk from 600 approved milk bank donors around the world to create comprehensive, geographically diverse nutrient profiles for DHM. We will then simulate the random pooling of 2 to 10 donors to evaluate the impact of pooling as a potential strategy for milk banks to manage nutrient variability in DHM. Finally, we will evaluate whether commercially available fortifiers meet nutrient recommendations when used with DHM.
We expect that results from this study will improve nutritional care globally for the growing number of preterm infants who receive donor human milk.
全球每年有近 1500 万婴儿早产，中低收入国家的早产儿比例不成比例。由于人乳具有预防坏死性小肠结肠炎的作用，世界卫生组织建议在没有母乳的情况下使用捐赠人乳（DHM）。DHM 的使用在全球范围内不断增加，许多中低收入国家将捐赠奶库纳入其公共卫生战略，以降低新生儿死亡率，但对于 DHM 的营养成分却知之甚少。其他知识空白包括 DHM 成分如何受到奶库实践的影响，以及当使用商业上可用的强化剂时，DHM 是否能达到早产儿的营养推荐量。
我们设计了一项多地点研究，有八个地理上多样化的奶库合作伙伴，分布在高、中、低收入环境中，该研究将对全球 600 名经批准的奶库捐赠者的母乳进行广泛的营养和生物活性因素检测和比较，以创建全面的、地理多样化的 DHM 营养成分谱。然后，我们将模拟随机混合 2 到 10 个捐赠者，以评估混合作为奶库管理 DHM 中营养变异性的潜在策略的影响。最后，我们将评估商业上可用的强化剂在与 DHM 一起使用时是否符合营养推荐量。
我们预计，这项研究的结果将改善全球越来越多接受捐赠人乳的早产儿的营养护理。
