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[Guidelines for multivitamin administration in fortified human milk prepared for preterm infants].
Arch Pediatr. 2017 Feb; 24(2):107-111.AP

Abstract

BACKGROUND

To reach nutritional standards, human milk has to have 2g/dL of protein. In 2013, Lafeber stated that when human milk is fortified up to 2g/dL, it may increase its osmolality up to 500 mOsm/kg. He also warned that care must be taken when adding a drug or vitamins to human milk.

AIM

We studied, for the first time, the impact of adding multivitamins (ADEC) on human fortified milk osmolality.

METHOD

The osmolality of 36 pasteurized, fortified human milk samples was measured. The amount of milk required as a solvent to maintain osmolality below 500 mOsm/kg was then determined.

RESULTS

The osmolality of 2mL of fortified human milk reached up to 750 mOsm/kg when the multivitamins ADEC was added. The osmolality decreased proportionately as the solution was diluted and if vitamins are added in two half-doses each time. It is only with 20mL of milk that the osmolality lowers to its initial rate of 430 mOsm/kg. The stronger the milk's fortification is, the greater impact it has on the milk's osmolality.

CONCLUSION

New nutritional recommendations for premature infants are needed. In the meantime, when the fortified milk intake is under 20mL, it is preferable to extend parenteral intakes with fat-soluble vitamins or reduce doses of vitamins in milk. Also, we should use enriched human milk as a fortifier and be cautious with indiscriminate fortification or when adding drugs and electrolyte solutions.

Authors+Show Affiliations

Réseau médical, lactarium régional d'Île-de-France, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France; NICU, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France. Electronic address: virginie.rigourd@nck.aphp.fr.Service de diagnostic biologique automatisé, HUPC, site Cochin, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.NICU, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France.NICU, hôpital Corbeil, 116, boulevard Jean-Jaures, 91106 Corbeil-Essonnes, France.NICU, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France.NICU, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France.NICU, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France.NICU, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France.Laboratoire Crinex, 3, rue de Gentilly, BP 337, 92541 Montrouge cedex, France.Réseau médical, lactarium régional d'Île-de-France, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France.Réseau médical, lactarium régional d'Île-de-France, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France.

Pub Type(s)

Journal Article

Language

fre

PubMed ID

28012639

Citation

Rigourd, V, et al. "[Guidelines for Multivitamin Administration in Fortified Human Milk Prepared for Preterm Infants]." Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, vol. 24, no. 2, 2017, pp. 107-111.
Rigourd V, Dridi Brahim I, Smii S, et al. [Guidelines for multivitamin administration in fortified human milk prepared for preterm infants]. Arch Pediatr. 2017;24(2):107-111.
Rigourd, V., Dridi Brahim, I., Smii, S., Razafimahefa, H., Quetin, F., Leroy, E., Pichon, C., Giuseppi, A., Berthier, L., Pommeret, B., & Serreau, R. (2017). [Guidelines for multivitamin administration in fortified human milk prepared for preterm infants]. Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, 24(2), 107-111. https://doi.org/10.1016/j.arcped.2016.11.003
Rigourd V, et al. [Guidelines for Multivitamin Administration in Fortified Human Milk Prepared for Preterm Infants]. Arch Pediatr. 2017;24(2):107-111. PubMed PMID: 28012639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Guidelines for multivitamin administration in fortified human milk prepared for preterm infants]. AU - Rigourd,V, AU - Dridi Brahim,I, AU - Smii,S, AU - Razafimahefa,H, AU - Quetin,F, AU - Leroy,E, AU - Pichon,C, AU - Giuseppi,A, AU - Berthier,L, AU - Pommeret,B, AU - Serreau,R, Y1 - 2016/12/21/ PY - 2016/02/23/received PY - 2016/11/03/revised PY - 2016/11/04/accepted PY - 2016/12/26/pubmed PY - 2018/2/15/medline PY - 2016/12/26/entrez SP - 107 EP - 111 JF - Archives de pediatrie : organe officiel de la Societe francaise de pediatrie JO - Arch Pediatr VL - 24 IS - 2 N2 - BACKGROUND: To reach nutritional standards, human milk has to have 2g/dL of protein. In 2013, Lafeber stated that when human milk is fortified up to 2g/dL, it may increase its osmolality up to 500 mOsm/kg. He also warned that care must be taken when adding a drug or vitamins to human milk. AIM: We studied, for the first time, the impact of adding multivitamins (ADEC) on human fortified milk osmolality. METHOD: The osmolality of 36 pasteurized, fortified human milk samples was measured. The amount of milk required as a solvent to maintain osmolality below 500 mOsm/kg was then determined. RESULTS: The osmolality of 2mL of fortified human milk reached up to 750 mOsm/kg when the multivitamins ADEC was added. The osmolality decreased proportionately as the solution was diluted and if vitamins are added in two half-doses each time. It is only with 20mL of milk that the osmolality lowers to its initial rate of 430 mOsm/kg. The stronger the milk's fortification is, the greater impact it has on the milk's osmolality. CONCLUSION: New nutritional recommendations for premature infants are needed. In the meantime, when the fortified milk intake is under 20mL, it is preferable to extend parenteral intakes with fat-soluble vitamins or reduce doses of vitamins in milk. Also, we should use enriched human milk as a fortifier and be cautious with indiscriminate fortification or when adding drugs and electrolyte solutions. SN - 1769-664X UR - https://www.unboundmedicine.com/medline/citation/28012639/[Guidelines_for_multivitamin_administration_in_fortified_human_milk_prepared_for_preterm_infants]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-693X(16)30533-4 DB - PRIME DP - Unbound Medicine ER -