Walter Leonie, Clifford Vanessa, Sulfaro Christine, Brown Richard, Ribeiro Daniel, Welvaert Marijke, Shuttleworth Glen, Klein Laura D
Strategy and Growth, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.
Pathology and Clinical Governance, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2023 Dec;59(12):1281-1288. doi: 10.1111/jpc.16497. Epub 2023 Oct 25.
This study aimed to characterise the between-batch variability of pasteurised donor human milk (PDHM) produced from single-donor pools at Australian Red Cross Lifeblood's milk bank and identify key donor characteristics that predict macronutrient content.
Macronutrient content from 200 batches of PDHM was measured using a mid-infrared human milk analyser (Miris, Uppsala, Sweden). Linear mixed models were used to study the impact of stage of lactation and gestational age on macronutrient content. Coefficients of determination (R ) were calculated to estimate the impact of the individual donor on overall variability.
Macronutrient content of PDHM varied considerably, with between-batch variations of 2.8 and 6.4-fold for protein and fat content, respectively. Mean crude protein content was 1.16 g/100 mL, ranging from 0.7 to 1.96 g/100 mL. Mean fat content was 3.85 g/100 mL, ranging from 1.46 to 9.39 g/100 mL. Stage of lactation was identified as a predictor for protein content and gestational age at birth for fat content. Individual donor effect explained 55 and 35% of the variance for fat and protein content, respectively.
This study highlights the variation in macronutrient content in PDHM at an Australian milk bank. Variability could be reduced through the implementation of targeted multiple-donor pooling using the key donor characteristics identified in this study along with the measurement of macronutrient content of individual donors at the time of first donation. However, the clinical benefit of a reduction in between-batch variation, achieved through multiple-donor pooling, would need to be assessed to justify additional efforts associated with PDHM processing changes.
本研究旨在描述澳大利亚红十字会生命血液中心母乳库中由单一供体乳汁混合制成的巴氏杀菌供体人乳（PDHM）的批次间变异性，并确定预测宏量营养素含量的关键供体特征。
使用中红外人乳分析仪（瑞典乌普萨拉的Miris）测量200批次PDHM的宏量营养素含量。采用线性混合模型研究泌乳阶段和胎龄对宏量营养素含量的影响。计算决定系数（R ）以估计个体供体对总体变异性的影响。
PDHM的宏量营养素含量差异很大，蛋白质和脂肪含量的批次间差异分别为2.8倍和6.4倍。平均粗蛋白含量为1.16 g/100 mL，范围为0.7至1.96 g/100 mL。平均脂肪含量为3.85 g/100 mL，范围为1.46至9.39 g/100 mL。泌乳阶段被确定为蛋白质含量的预测指标，出生时的胎龄为脂肪含量的预测指标。个体供体效应分别解释了脂肪和蛋白质含量方差的55%和35%。
本研究突出了澳大利亚母乳库中PDHM宏量营养素含量的变异性。通过利用本研究确定的关键供体特征进行有针对性的多供体混合，并在首次捐赠时测量个体供体的宏量营养素含量，可以降低变异性。然而，通过多供体混合实现的批次间变异性降低的临床益处，需要进行评估，以证明与PDHM加工变化相关的额外努力是合理的。
