Human milk enriched with human milk lyophilisate for feeding very low birth weight preterm infants: A preclinical experimental study focusing on fatty acid profile

• Published in: PloS one Vol. 13; no. 9; p. e0202794
• Main Authors: Bomfim, Vanessa S, Jordão, Junior, Alceu A, Alves, Larissa G, Martinez, Francisco E, Camelo, Jr, José Simon
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 25.09.2018; Public Library of Science (PLoS)
• Subjects: Additives; Adolescent; Adult; Antioxidants; Arachidonic acid; Babies; Baby foods; Biology and Life Sciences; Birth weight; Breast; Breast milk; Breastfeeding & lactation; Central nervous system; Children; Chromatography, Gas; Docosahexaenoic acid; Essential nutrients; Fatty acids; Fatty Acids - analysis; Female; Food; Food and nutrition; Freeze Drying; Gas chromatography; Humans; Infant Food; Infant Formula - chemistry; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight - growth & development; Infants; Linoleic acid; Linolenic acid; Lipid peroxidation; Lipids; Lipids - analysis; Low birth weight; Medical schools; Medicine and Health Sciences; Metabolism; Milk; Milk, Human - chemistry; Mothers; Neonates; Newborn babies; Nutrients; Nutrition research; Nutritional aspects; Oleic acid; Palmitic acid; Pasteurization; Pediatrics; People and Places; Peroxidation; Polyunsaturated fatty acids; Premature babies; Premature birth; Premature infants; Proteins; Research and Analysis Methods; Retina; Storage; Weight; Young Adult; Brazil
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0202794

Human milk, with essential nutrients and long chain polyunsaturated fatty acids (LC-PUFAs) such as the omega 3 and 6 fatty acids is important for development of the central nervous system and the retina in very low birth weight infants (<1,500 g). However, breast milk may not be sufficient to meet these needs. The possibility of supplementing breast milk with a lyophilisate of human milk was explored in this study. The objectives of this study were to determine the total lipid content and the lipid profile of the Human Milk on Baseline (HMB) and that of the Concentrates with the Human Milk + lyophilisate (with lyophilisate of milk in the immediate period (HMCI), at 3 months (HMC3m), and at 6 months (HMC6m) of storage). Fifty donors from the Human Milk Bank of Children's Hospital provided consent, and donated milk samples. Macronutrient (including total lipids) quantification was performed using the MIRIS® Human Milk Analyzer, and the fatty acid profile was determined by gas chromatography (CG-FID, SHIMADZU®). There was a higher lipid concentration in HMCI relative to HMB. The concentrations of the main fatty acids (% of total) were as follows: palmitic acid (C16:0) HMB, 22.30%; HMCI, 21.46%; HMC3m, 21.54%; and HMC6m, 21.95% (p<0.01); oleic acid (C18:1n-9) HMB, 30.41%; HMCI, 30.47%; HMC3m, 30.55%; and HMC6m, 29.79% (p = 0.46); linoleic acid (C18:2n-6) HMB, 19.62%; HMCI, 19.88%; HMC3m, 19.49%; and HMC6m, 19.45% (p = 0.58); arachidonic acid (C20:4n-6) HMB, 0.35%; HMCI, 0.16%; HMC3m, 0.13%; and HMC6m, 0.15% (p<0.01); α-linolenic acid (C18:3n-3) HMB,1.32%; HMCI, 1.37%; HMC3m, 1.34%; and 1.34% HMC6m (p = 0.14); docosahexaenoic acid (C22:6n-3) HMB, 0.10%; HMCI, 0.06%; HMC3m, 0.05%; and HMC6m, 0.06% (p<0.01). There were no significant changes in the lipid profile when stored. There was no evidence of peroxidation during storage. Freeze-dried human milk fortified with a human milk concentrate brings potential benefits to newborns, mainly by preserving the essential nutrients present only in breast milk; however, further clinical studies are required to evaluate the safety and efficacy of the concentrate as a standard nutritional food option for very low birth weight infants.