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Effect of fortification on the osmolality of human milk.
J Med Assoc Thai. 2006 Sep; 89(9):1400-3.JM

Abstract

BACKGROUND

Human milk is nutritionally better than formula milk for preterm infants. However, unfortified human milk may fail to meet the theoretical requirements of very low birth weight (VLBW). Human milk fortifier (HMF) increases the nutritional content of human milk. However, the important factor of concern in feeding VLBW is the osmolality, the higher the osmolality, the greater the risk of necrotizing entero colitis (NEC). Therefore, high osmolality in fortified human milk should be considered for this condition.

OBJECTIVE

To evaluate the effect of fortification on the osmolality of human milk.

MATERIAL AND METHOD

Twenty samples of human milk were collected from mothers of gestational age less than 32 weeks, at about 1 week postpartum in Songklanagarind Hospital. The osmolality of each sample was determined at baseline and after supplementation with HMF at 10 minutes, 1, 2, 4, and 6 hours at room temperature and 24 hours at 4 degrees C in a refrigerator.

RESULTS

The mean osmolalities (SD) of human milk and HMF dissolved in sterile water were 285.3 (3.3) mOsm/kg H2O and 64.6 (0.7) mOsm/kg H2O, respectively. Thus, the expected osmolality of human milk after supplementation with HMF was 349 mOsm/kg H2O. Mean measured osmolalities (SD) of human milk after supplementation with HMF at 10 minutes, and 1, 2, 4, 6 and 24 hours was 394.7 (2.9), 399.5 (2.8), 402.1 (2.2), 401.0 (2.7), 401.3 (2.3) and 401.2 (3.1) mOsm/kg H2O, respectively. The mean osmolality at 10 minutes, 1, 2, 4, 6 and 24 hours were significantly higher than human milk (p < 0.001) and the mean osmolality at 10_minutes was significantly higher than expected osmolality (p < 0.001). There were no significant differences among groups of osmolality after supplementation with HMF at 10 minutes, 1, 2, 4, 6, and 24 hours (p > 0.05).

CONCLUSION

The supplementation of human milk with HMF induced an increase in osmolality after mixing. The osmolality, after mixing with HMF which was about 400 mOsm/kg H2O, creates a greater risk of NEC. Therefore, HMF milk should be considered for feeding in only high risk preterm neonates.

Authors+Show Affiliations

Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17100376

Citation

Janjindamai, Waricha, and Thirachit Chotsampancharoen. "Effect of Fortification On the Osmolality of Human Milk." Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 89, no. 9, 2006, pp. 1400-3.
Janjindamai W, Chotsampancharoen T. Effect of fortification on the osmolality of human milk. J Med Assoc Thai. 2006;89(9):1400-3.
Janjindamai, W., & Chotsampancharoen, T. (2006). Effect of fortification on the osmolality of human milk. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 89(9), 1400-3.
Janjindamai W, Chotsampancharoen T. Effect of Fortification On the Osmolality of Human Milk. J Med Assoc Thai. 2006;89(9):1400-3. PubMed PMID: 17100376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of fortification on the osmolality of human milk. AU - Janjindamai,Waricha, AU - Chotsampancharoen,Thirachit, PY - 2006/11/15/pubmed PY - 2007/1/24/medline PY - 2006/11/15/entrez SP - 1400 EP - 3 JF - Journal of the Medical Association of Thailand = Chotmaihet thangphaet JO - J Med Assoc Thai VL - 89 IS - 9 N2 - BACKGROUND: Human milk is nutritionally better than formula milk for preterm infants. However, unfortified human milk may fail to meet the theoretical requirements of very low birth weight (VLBW). Human milk fortifier (HMF) increases the nutritional content of human milk. However, the important factor of concern in feeding VLBW is the osmolality, the higher the osmolality, the greater the risk of necrotizing entero colitis (NEC). Therefore, high osmolality in fortified human milk should be considered for this condition. OBJECTIVE: To evaluate the effect of fortification on the osmolality of human milk. MATERIAL AND METHOD: Twenty samples of human milk were collected from mothers of gestational age less than 32 weeks, at about 1 week postpartum in Songklanagarind Hospital. The osmolality of each sample was determined at baseline and after supplementation with HMF at 10 minutes, 1, 2, 4, and 6 hours at room temperature and 24 hours at 4 degrees C in a refrigerator. RESULTS: The mean osmolalities (SD) of human milk and HMF dissolved in sterile water were 285.3 (3.3) mOsm/kg H2O and 64.6 (0.7) mOsm/kg H2O, respectively. Thus, the expected osmolality of human milk after supplementation with HMF was 349 mOsm/kg H2O. Mean measured osmolalities (SD) of human milk after supplementation with HMF at 10 minutes, and 1, 2, 4, 6 and 24 hours was 394.7 (2.9), 399.5 (2.8), 402.1 (2.2), 401.0 (2.7), 401.3 (2.3) and 401.2 (3.1) mOsm/kg H2O, respectively. The mean osmolality at 10 minutes, 1, 2, 4, 6 and 24 hours were significantly higher than human milk (p < 0.001) and the mean osmolality at 10_minutes was significantly higher than expected osmolality (p < 0.001). There were no significant differences among groups of osmolality after supplementation with HMF at 10 minutes, 1, 2, 4, 6, and 24 hours (p > 0.05). CONCLUSION: The supplementation of human milk with HMF induced an increase in osmolality after mixing. The osmolality, after mixing with HMF which was about 400 mOsm/kg H2O, creates a greater risk of NEC. Therefore, HMF milk should be considered for feeding in only high risk preterm neonates. SN - 0125-2208 UR - https://www.unboundmedicine.com/medline/citation/17100376/Effect_of_fortification_on_the_osmolality_of_human_milk_ L2 - https://www.lens.org/lens/search?q=citation_id:17100376 DB - PRIME DP - Unbound Medicine ER -