Improving fortification with weekly analysis of human milk for VLBW infants

Objective: To track individual mother’s macronutrient variability in preterm human milk (HM) over 6 weeks of lactation. Study Design: This was a prospective, observational study of mother’s own milk from women who delivered a very low birth weight infant (<1500 g). A single, random maternal breast milk sample was collected and analyzed weekly for 6 consecutive weeks. Analysis was by mid-infrared spectroscopy. Results: Twenty women consented to provide at least one milk sample. Fat, protein and energy content varied widely among mothers and by week of lactation. Energy content ranged from 9.5 to 30.4 kcal oz −1 across the study period. Twenty-five percent of all samples had an energy content <17 kcal oz −1 . Protein content ranged from 1.1 to 2.8 g dl −1 in the first week. Sixty-three percent of all samples had a protein content <1.5 g dl −1 . Fat and energy showed trends of increasing concentrations, whereas protein showed the expected decline over time. Lactose showed little variability by woman or by week of lactation. Conclusion: HM fat and protein content varied widely by individual woman over time. Week-to-week variability in fat and protein can impact growth. The ability to analyze HM is helpful to improve fortification of HM.