327 - Generation of cream from mother's own milk for supplementation of fortified feeds - Making Strides Towards Accuracy and Reliability

Publication Number: 3316.327

Yasmina Samaha, University of Rochester, Golisano Children's Hospital, Rochester, NY, United States; Trenton S. Scherger, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States; Laura E. Cole, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States; Joseph M. Bliss, University of Rochester Medical Center, Rochester, NY, United States; Bridget Young, University of Rochester, Golisano Children’s Hospital, Rochester, NY, United States

Background: Premature infants have unique metabolic needs that necessitate fortification of human milk. Addition of cream from pasteurized donor milk is a common strategy to enhance caloric density of feedings. Adding fat from unpasteurized mother's own milk (MOM) may provide additional benefit by retaining bioactive components lost in pasteurization including the milk fat globule membrane and exosomes.

Objective: To develop a protocol for reliable generation of cream derived from MOM (MOM-Cream) that consistently provides 13.1 kcal in 5mL (equivalent to commercial products).

Design/Methods: Thirty human milk pools were generated from discarded premature human milk (raw MOM). The macronutrient profile of each pool was assessed via mid-infrared spectroscopy (Miris Human Milk Analyzer, Uppsala, Sweden). In initial tests to determine efficiency of fat retention, the same volume of four raw MOM with varied caloric densities was drawn up into sterile single-use syringes and centrifuged at 4˚C for 20 minutes at 3,000xg. After centrifugation, MOM-Skim (infranatant) and MOM-Cream (supernatant) were expressed from the syringe into separate tubes. MOM-Cream was reconstituted with raw MOM to a 5mL total volume. Reconstituted MOM-Cream samples were analyzed for caloric and macronutrient content. The macronutrient content of the final product was used to determine the efficiency of fat retention from centrifugation.
Using this estimate of efficiency, the volume of raw MOM necessary to generate 5mL of cream containing 13.1kcal (based on a commercial donor milk cream product) was calculated based on the caloric density of the raw MOM for each pool. Thirty different MOM-Cream products were generated.

Results: The efficiency of fat retention observed in the initial experiments and utilized in the final cream generation calculations was 85%. The macronutrient content of MOM-Cream (Table 1) was 13.07 ± 0.99 kcal/ 5 mL, 1.24 ± 0.10 g fat/ 5 mL, 0.31 ± 0.02 g carbohydrate/ 5 mL, and 0.07 ± 0.02 g protein/ 5 mL.
The average caloric density of MOM-Cream differed from the target caloric density, by 0% ± 8% (p=0.859). The macronutrient profile of MOM-Cream differed from that of a commercial cream product: fat was 5% ± 8% lower (p=0.0018), carbohydrate was 10% ± 7% lower (p < 0.0001), and protein was 39% ± 31% higher (p < 0.0001).

Conclusion(s): For mothers with excess MOM available, MOM-Cream can be effectively and reliably generated via centrifugation with equivalent energy content to a commercial cream product.

Table 1: A comparison of average energy and macronutrient composition in generated MOM-Cream to Commercial Cream.