Arch Dis Child Fetal Neonatal Ed 1999;81:F141-F143
( September )
Effect of fortification on the osmolality of human milk
M De Curtisa b, M Candussoa, C Pieltaina, J Rigoa
a This
work was presented in part at the European Society for Pediatric
Research Meeting in Belfast, September 13-16, 1998 Neonatal Unit University
of Liège Hôpital de la Citadelle
CHR Citadelle 4000 Liège Belgium, b Istituto Materno-Infantile
University of Palermo
Italy
Correspondence to: Professor J Rigo.
Email: J.Rigo{at}ulg.ac.be
Accepted 7 April 1999
AIM
To evaluate the effect of
fortification on the osmolality of human milk.
METHODSThe osmolality of 47 samples of human milk was determined at baseline, just after, and 24 hours after supplementation with five different human milk fortifiers
(HMF) at 4°C.
RESULTSTen minutes after HMF
supplementation the osmolality of human milk was significantly higher
than the sum of the respective values of HMF dissolved in water and
human milk, measured separately at baseline (p<0.0001), with the
exception of the HMF containing only proteins. After 24 hours a further
increase in osmolality was observed. Linear regression analysis showed
that total dextrin content (r=0.84) was the main determinant of the increase.
CONCLUSIONSHuman milk and HMF
interact to induce a rapid increase in osmolality higher than would be
expected from composition alone. This rise could be explained by the
amylase activity of human milk, inducing hydrolysis of the dextrin
content of HMF, leading to small osmotically active molecules of
oligosaccharides. The high osmolality of fortified human milk should be
considered in the nutritional management of preterm infants.
Keywords:
human milk;
fortifiers;
osmolality
© 1999 by Archives of Disease in Childhood
