384 - Macronutrient Discordance in Donor Breast Milk

Publication Number: 3371.384

Anika Pulickal, Winter Springs High School, Orlando, FL, United States; William NMN. Oh, Women and Infants' Hospital, Barrington, RI, United States; Anoop Pulickal, AdventHealth for Children, Orlando, FL, United States

Background: Donor breast milk is the preferred nutrition in preterm infants when maternal breast milk is unavailable or contraindicated. It is important to accurately determine the baseline caloric content and macronutrient composition in donor breast milk prior to effecting targeted nutritional fortification of the same. This is achieved with two commonly used infrared human milk analyzers: full spectra mid-infrared instrument and filtered mid-infrared instrument. However, there is a lack of data on differences in results between these two techniques.

Objective: The objectives of this study were to determine the caloric estimate and macronutrient contents in donor breast milk when calculated using full spectra mid-infrared analyzer and filtered mid-infrared analyzer.

Design/Methods: Two categories of batched donor breast milk – 20 kcal/oz (n=175) and 24 kcal/oz (n=55) were tested with both analyzers to determine the caloric, protein, carbohydrate and fat contents. Comparisons were performed using t-tests or Wilcoxon tests.

Results: There were no significant differences in the mean caloric content using both analyzers for the 20 kcal/oz milk (p=0.113) and 24 kcal/oz milk (p=0.093). However, for 20kcal/oz milk, there were significant differences in mean protein (0.96 g/dL vs. 0.85 g/dL; p< 0.001), carbohydrate (7.32 g/dL vs. 8.4 g/dL; p< 0.001) and fat (3.41 g/dL vs. 3.7 g/dL; p< 0.001) content. Similarly, for 24kcal/oz milk, significant differences in mean protein (1.04 g/dL vs. 0.92 g/dL, p< 0.001), carbohydrate (8.35 g/dL vs. 7.26 g/dL; p< 0.001) and fat (5.23 g/dL vs. 4.84 g/dl; p< 0.001) content were observed.

Conclusion(s): There is significant macronutrient discordance in donor breast milk analysis when determined using two different but commonly used techniques. This has implications for the accuracy of targeted fortification of donor breast milk in preterm infants in the NICU. Further studies are needed to determine the optimal adjustment formulae of nutritional components in donor breast milk based on the analytical results by full spectra mid-infrared analyzer or filtered mid-infrared analyzer.