A comparison of methods for determination of total lipids in human milk

A modified Folch extraction, a Celite-Na₂SO₄ column elution, a spectrophotometric method and the creamatocrit method for total lipid analysis of human milk were compared against the Roese-Gottlieb method. The constant, proportional and random errors associated with each method were determined. Pooled milk was centrifuged to separate milk lipid and skim milk. Varying concentrations of milk lipid were reintroudced into the skim milk to provide 25 samples for analysis with a range of lipids from approximately 0.5 to 8.0 percent. There was a high correlation (r>0.977) between the Roese-Gottlieb method and all methods evaluated. A least squares equation was developed between the Roese-Gottlieb method and each method tested. The greatest constant error, as estimated by the least squares y-intercept, was observed with the Celite Na₂SO₄ column procedure and spectrophotometric method. The greatest proportional error as estimated by the slope was observed with the Celite-Na₂SO₄ column procedure. Random error based on the least squares standard error of estimate in the y direction was greatest for the spectrophotometric method. While there are differences between methods, with careful standardization all the methods tested could provide satisfactory results for analysis of total lipids in human milk.     

Do Maternal Factors and Milk Expression Patterns Affect the Composition of Donor Human Milk?

A primary role of Human Milk Banks (HMBs) is to provide human milk (HM) for preterm infants and to support the mothers of these infants as they establish their own milk supply. A better understanding of the variation in the energy and macronutrients contents of donor human milk (DHM) potentiates targeted nutrition for preterm babies. Therefore, the aim of this study was to assess the variability of energy and macronutrients content in DHM and to investigate the impact of maternal factors and feeding practices on the nutritional value of DHM. The study involved 49 donors registered in the HMB in the Holy Family Hospital in Warsaw, Poland. Samples from each donor were pooled within a maximum of two weeks. The composition of DHM, including energy content, protein, fat, and carbohydrate concentrations, was analyzed using the Miris Human Milk Analyzer. The analyses were performed before the pasteurization process. The mean time of milk donation to HMB was 13.2 ± 6.0 weeks. There were no significant differences in energy and macronutrients contents of DHM in the beginning and at the end of milk donation to HMB, however, HM fat concentration was positively correlated with afternoon feedings (r = 0.289, p = 0.044). The method of feeding (breastfeeding vs. feeding only expressed milk) also did not impact the nutritional value of DHM. Future research for the DHM should include a further cross-sectional observational study with the collection of detailed donor information and characteristics of milk expression and feeding practices to further evaluate the pooling processes and the effect on DHM composition.     

牛奶与奶粉中硫氰酸根的离子色谱法测定法中不同淋洗液体系测定的结果

目的比较碳酸盐体系和氢氧根体系离子色谱法测定牛奶与奶粉中硫氰酸根的方法参数。方法样品用乙腈沉淀蛋白,取上清稀释后,过OnGuard RP柱（2．5cc）去除脂肪,经离子色谱柱分离,电导检测器检测,以保留时间定性,外标法定量。结果碳酸盐体系离子色谱法检出限牛奶为0．25ms／ks,奶粉为1．0mg／ks,RSD％小于3．0％,回收率为80．O％-110．0％;氢氧根体系离子色谱法检出限牛奶为0．1mg／kg,奶粉为0．4mg／kg,RSD％小于2．0％,回收率为90．0％-108．8％。结论2种淋洗液体系离子色谱法均可作为牛奶和奶粉中硫氰酸根的检测方法,但氢氧根体系离子色谱法可得到更低的检出限。     

Human Milk Microbiota and Oligosaccharides: A Glimpse into Benefits,Diversity, and Correlations

Human milk represents a cornerstone for growth and development of infants, with extensive array of benefits. In addition to exceptionally nutritive and bioactive components, human milk encompasses a complex community of signature bacteria that helps establish infant gut microbiota, contributes to maturation of infant immune system, and competitively interferes with pathogens. Among bioactive constituents of milk, human milk oligosaccharides (HMOs) are particularly significant. These are non-digestible carbohydrates forming the third largest solid component in human milk. Valuable effects of HMOs include shaping intestinal microbiota, imparting antimicrobial effects, developing intestinal barrier, and modulating immune response. Moreover, recent investigations suggest correlations between HMOs and milk microbiota, with complex links possibly existing with environmental factors, genetics, geographical location, and other factors. In this review, and from a physiological and health implications perspective, milk benefits for newborns and mothers are highlighted. From a microbiological perspective, a focused insight into milk microbiota, including origins, diversity, benefits, and effect of maternal diet is presented. From a metabolic perspective, biochemical, physiological, and genetic significance of HMOs, and their probable relations to milk microbiota, are addressed. Ongoing research into mechanistic processes through which the rich biological assets of milk promote development, shaping of microbiota, and immunity is tackled.     

IRON ABSORPTION FROM BREAST MILK OR COW'S MILK

A clinical study provided support for the proposition that human infants absorb iron more efficiently from human milk than from COW'S milk.     

Century Wide Changes in Macronutrient Levels in Indian Mothers’ Milk: A Systematic Review

The purpose of this systematic review was to understand Indian mothers’ milk composition and report changes in it over the past 100 years. A review was conducted in accordance with PRISMA and registered with PROSPERO (CRD42022299224). All records published between 1921 and 2021 were identified by searching databases Google Scholar, ResearchGate, PubMed, and the Cochrane Database of Systematic Reviews. All observational, interventional, or supplementation studies reporting macronutrients (protein, fat, lactose) in milk of Indian mothers, delivering term infants, were included. Publications on micronutrients, preterm, and methods were excluded. Milk was categorized into colostrum, transitional, and mature. In all, 111 records were identified, of which 34 were included in the final review. Fat ranged from 1.83 to 4.49 g/100 mL, 2.6 to 5.59 g/100 mL, and 2.77 to 4.78 g/100 mL in colostrum, transitional, and mature milk, respectively. The protein was higher in colostrum (1.54 to 8.36 g/100mL) as compared to transitional (1.08 to 2.38 g/100 mL) and mature milk (0.87 to 2.33 g/100 mL). Lactose was lower in colostrum (4.5–6.47 g/100 mL) as compared to transitional (4.8–7.37 g/100 mL) and mature milk ranges (6.78–7.7 g/100 mL). The older studies (1950–1980) reported higher fat and protein in colostrum as compared to subsequent time points. There were variations in maternal nutritional status, diet, socioeconomic status, and regions along with study design specific differences of time or methods of milk sampling and analysis. Additionally, advancements in methods over time make it challenging to interpret time trends. The need for conducting well-designed, multicentric studies on nutrient composition of Indian mother’s milk using standardized methods of sampling and estimation for understanding the role of various associated factors cannot be undermined.     

母乳和牛奶中铜、铁、锌、锰、铬含量的比较

以原子吸收光谱法测定产后不同泌乳时期(1～90天)母乳及牛奶中铜、铁、锌、锰、铬的含量变化/结果表明,母乳中铜、铁、锌,锰的含量随泌乳期延长而下降,铬无显著变化。母乳中铜、铁、锌、铬的含量均较牛奶丰富。母乳喂养和牛奶喂养婴儿每日微量元素摄入量与其摄入推荐量相比较:母乳微量元素的营养价值较牛奶高。本研究为提倡母乳喂养,指导牛奶喂养者补充微量元素提供了科学依据。     

Whole Goat Milk as a Source of Fat and Milk Fat Globule Membrane in Infant Formula

Cow milk is the most common dairy milk and has been extensively researched for its functional, technological and nutritional properties for a wide range of products. One such product category is infant formula, which is the most suitable alternative to feed infants, when breastfeeding is not possible. Most infant formulas are based on cow milk protein ingredients. For several reasons, consumers now seek alternatives such as goat milk, which has increasingly been used to manufacture infant, follow-on and young child formulas over the last 30 years. While similar in many aspects, compositional and functional differences exist between cow and goat milk. This offers the opportunity to explore different formulations or manufacturing options for formulas based on goat milk. The use of whole goat milk as the only source of proteins in formulas allows levels of milk fat, short and medium chain fatty acids, sn-2 palmitic acid, and milk fat globule membrane (MFGM) to be maximised. These features improve the composition and microstructure of whole goat milk-based infant formula, providing similarities to the complex human milk fat globules, and have been shown to benefit digestion, and cognitive and immune development. Recent research indicates a role for milk fat and MFGM on digestive health, the gut–brain axis and the gut–skin axis. This review highlights the lipid composition of whole goat milk-based infant formula and its potential for infant nutrition to support healthy digestion, brain development and immunity. Further work is warranted on the role of these components in allergy development and the advantages of goat milk fat and MFGM for infant nutrition and health.     

Nutritional and physiologic significance of alpha-lactalbumin in infants

α-Lactalbumin is the major protein in breast milk (20 -25% of total protein) and has been described to have several physiologic functions in the neonatal period. In the mammary gland, it participates in lactose synthesis, thereby creating an osmotic "drag" to facilitate milk production and secretion. α-Lactalbumin binds divalent cations (Ca, Zn) and may facilitate the absorption of essential minerals, and it provides a well-balanced supply of essential amino acids to the growing infant. During its digestion, peptides appear to be transiently formed that have antibacterial and immunostimulatory properties, thereby possibly aiding in the protection against infection. A novel folding variant ("molten globule state") of multimeric α-lactalbumin has recently been discovered that has anti-infective activity and enhances apoptosis, thus possibly affecting mucosal cell turnover and proliferation. Cow milk also contains α-lactalbumin, albeit less than human milk (2-5% of total protein in bovine milk), and protein fractions enriched with α-lactalbumin may now be added to infant formula to provide some of the benefits of human α-lactalbumin.     

仪器中子活化分析法测定人乳、牛奶和奶粉中的十四种常量和微量元素

本文介绍了用仪器中子活化分析法测定人乳、牛奶和多种奶粉中钠、钾、氯、镁、钙、铝、溴、铁、钴、锌、硒、锰、铬和铷等十四种常量和微量元素的分析程序及分析结果,并对数据反映的问题进行了初步讨论。     

配方奶和母乳喂养儿第一年瘦素水平和体格发育指标的比较

【目的】研究中国婴儿配方奶喂养和母乳喂养时第一年血清瘦素水平和体格发育指标的差异。【方法】选取配方奶喂养儿45人(其中男24人,女21人),母乳喂养儿51人(其中男27人,女24人)进行对照研究,分别检查6个月和1岁时的血清瘦素浓度和体格发育指标。【结果】①配方组婴儿6个月时身高、体重和体质指数(body massindex,BMI)高于母乳组,但差异无显著性(P>0.05),瘦素浓度则明显低于母乳组(P<0.05);配方组婴儿1岁时体重和BMI较母乳组高,差异且有显著性(P<0.05);配方组身高稍高于母乳组,但差异无显著性(P>0.05),而瘦素浓度在配方组仍明显低于母乳组(P<0.05),但差别有所缩小。【结论】中国婴儿配方奶喂养和母乳喂养时第一年血清瘦素水平和体格发育指标的差异明显。     

食品牛奶中7种元素的含量分布及营养分析

对市售袋装牛奶中钙、磷、镁、铁、锰、锌和铜 7种元素进行了测定 ,比较了各元素在牛奶中的含量分布 ,并与人体血液中相应元素的含量分布以及人体每日推荐量进行了对比 ,分析了三者之间的相似性及差异 ,对7种元素的比例与人体营养关系进行了初步分析.     

Protein Enrichment of Donor Breast Milk and Impact on Growth in Very Low Birth Weight Infants

Protein content is often inadequate in donor breast milk (DBM), resulting in poor growth. The use of protein-enriched target-pooled DBM (DBM+) has not been examined. We compared three cohorts of very low birth weight (VLBW) infants, born ≤ 1500 g: DBM cohort receiving > 1-week target-pooled DBM (20 kcal/oz), MBM cohort receiving ≤ 1-week DBM, and DBM+ cohort receiving > 1-week DBM+. Infants followed a standardized feeding regimen with additional fortification per clinical discretion. Growth velocities and z-scores were calculated for the first 4 weeks (n = 69 for DBM, 71 for MBM, 70 for DBM+) and at 36 weeks post-menstrual age (n = 58, 64, 59, respectively). In total, 60.8% MBM infants received fortification >24 kcal/oz in the first 30 days vs. 78.3% DBM and 77.1% DBM+. Adjusting for SGA, length velocity was greater with DBM+ than DBM in week 1. Average weight velocity and z-score change were improved with MBM compared to DBM and DBM+, but length z-score decreased similarly across all groups. Incidences of NEC and feeding intolerance were unchanged between eras. Thus, baseline protein enrichment appears safe in stable VLBW infants. Weight gain is greatest with MBM. Linear growth comparable to MBM is achievable with DBM+, though the overall length trajectory remains suboptimal.     

乳制品中核黄素荧快速荧光测定法

根据Na_2 S_2O_4可使VB_2产生的荧光熄灭性质,以国产930型荧光光度计测定样品加Ne_2S_2O_4前后的荧光强度,按照前后两次荧光强度的差值,求出样品中VB_2含量,从而清除杂质荧光对测定的干扰。将样品加温加压酸解提取改进为室温常压下酸解提取。并用pH4.6醋酸盐缓冲液沉淀样品中蛋白质。本方法测定不同乳制品的平均回收率为93％～100％,变异系数为5.75％～12.8％。     

Human Milk for Ill and Medically Compromised Infants

The use of human milk (mother's own milk and/or donor milk) in ill or medically compromised infants frequently requires some adaptation to address medical diagnoses and/or altered nutrition requirements. This tutorial describes the nutrition and immunological benefits of breast milk as well as provides evidence for the use of donor milk when mother's own milk is unavailable. Several strategies used to modify human milk to meet the medical and nutrition needs of an ill or medically compromised infant are reviewed. These strategies include (1) the standard fortification of human milk to support adequate growth, (2) the novel concept of target fortification in preterm infants, (3) instructions on how to alter maternal diet to address cow's milk protein intolerance and/or allergy in breast milk–fed infants, and (4) the removal and modification of the fat in breast milk used in infants diagnosed with chylothorax.     

乳和乳制品中沙门氏菌限量标准研究

以乳和乳制品中沙门氏菌限量标准为例,对影响其制定的诸多因素进行综述,以期为我国食品微生物限量标准的修订提供线索。     

Energy and Fat Intake for Preterm Infants Fed Donor Milk Is Significantly Impacted by Enteral Feeding Method

Background: Pasteurized donor milk is the recommended supplement for preterm infants when mother's milk volumes are insufficient. Compared with mother's milk, the macronutrient content of donor milk is thought to be lower due to pasteurization and additional container changes during processing. Given that poor growth is concerning for preterm infants, it is important to understand how processing and feeding methods influence the nutrition composition of donor milk feeds. The research aim of this study was to determine the effects of pasteurization and feeding method on the macronutrient and energy composition of donor milk. Ten donor milk pools were pasteurized, prepared according to neonatal practices, and infused through nasogastric tubes to simulate 4 feeding methods: bolus, 30 minutes, 60 minutes, and continuous feeding over 4 hours. Macronutrient concentrations were assessed after pasteurization, preparation, and each feeding method using a mid‐infrared human milk analyzer. Results: There were no significant decreases in macronutrient content after pasteurization or bolus feeding. However, energy and fat losses increased with slower infusion rates. After continuous feeding for 4 hours, energy and fat concentrations decreased by a mean of 17.3 (15.8–18.8) kcal/dL and 2.08 (1.90–2.25) g/dL (P < .0001), respectively. Conclusions: Pasteurization did not significantly reduce donor milk macronutrient and energy content; however, feeding method significantly impacted the final delivery of energy and fat.     

Consumption Patterns and Preference of Milk and Milk Products among Rural and Urban Consumers in Semi-Arid Kenya

Milk consumption in the semi-arid regions of Kenya is not well understood. A study was carried out on consumption of milk and milk products in the semi-arid region of eastern Kenya. A total of 135 rural and 126 urban households were interviewed. Raw milk was the most popular and was consumed by 99% and 84% of rural and urban households, respectively. Generally as degree of processing increased, the frequency of consumption declined from more than once per day to 1–2 times a week and eventually to occasionally. Richer households consumed significantly (p < .05) more milk and milk products than poor households. Raw milk was preferred over pasteurized, ultra high temperature treated, and powdered milk because it was cheaper and widely available. In order to improve consumption of different milk products, there is need to improve availability particularly in the rural areas.     

早产儿生后早期母乳营养成分变化分析

目的 分析早产儿生后早期母乳各大营养成分变化的特点,初步探讨提供早产儿个性化营养支持的必要性。 方法 收集2017年1-12月在南京医科大学附属常州妇幼保健院分娩产妇70人的母乳140份,用MIRIS母乳分析仪检测母乳中宏量营养成分及能量,比较不同早产儿性别、乳母年龄和不同分娩方式初乳和过渡乳母乳营养成分的差异及随着出生天数所发生的变化。 结果 1)早产母乳中初乳蛋白质含量大于过渡乳(P<0.01);初乳的脂肪、碳水化合物和能量低于过渡乳(P<0.05)。2)≤ 30周早产初乳蛋白质含量最高,与30⁺¹~33⁺⁶周组和≥34周组比较差异有统计学意义(P<0.05);≤ 30周早产初乳能量显著低于30⁺¹~33⁺⁶周(P<0.05),而脂肪、碳水化合物差异无统计学意义(P>0.05);3)不同胎龄的三组过渡乳中蛋白质、脂肪、能量差异均无统计学意义(P>0.05);碳水化合物分别为(6.28±0.57)、(6.61±0.43)、(6.36±0.81) g/100 ml,随着孕周增加而增加,差异有统计学意义(P＝0.04)。4)母乳营养成分含量在孕母生育年龄、分娩方式、婴儿性别、出生体重方面差异均无统计学意义。5)线性拟合后发现母乳中蛋白质在生后持续下降,其折点天数在第11天,同时,线性拟合发现脂肪、糖类和能量含量呈增长趋势,脂肪变化的折点在出生后第9天,而糖类以及能量在出生14 d内呈近似线性增长关系。结论 早产初乳、过渡乳营养成分差异显著,母乳营养成分含量与孕母生育年龄、分娩方式、婴儿性别、出生体重无相关性。早产儿早期蛋白质累计缺乏以及蛋白质/热卡比例较低,且早产母亲母乳成分的个体差异较大,应该对母乳中蛋白质含量和热卡密度进行“目标性”强化,对母乳添加剂添加需进一步研究。