An audit of preterm nutritional intake using a human milk analyser

Jones E., Bell S., Shankar S. Infant 2012; 8(3): x-x.

Human milk is considered the best choice for nutrition in both term and preterm infants1. However, after the first 2- 3 weeks of lactation the protein and energy content of human milk is usually insufficient to meet the nutritional demands of rapidly growing preterm infants2. Since protein is essential for neurocognitive development and growth in preterm infants3, mothers own breast milk is fortified according to manufacturers’ instructions based on an assumed macronutrient composition. However, since the composition of human milk is extremely variable, this can result in either over or under fortification4. Infrared (IR) spectroscopy has proven to be a useful analytical tool for determining the macro-nutrient content of human milk5-7. Recently, a mid – IR (MIR) human milk analyser (HMA) has been developed by Miris AB (Uppsala, Sweden) (FIGURE 1). The HMA is calibrated with human milk standards and can measure fat, protein, lactose and total solids simultaneously in human milk. Currently clinical practice on the neonatal intensive care unit (NICU) at the University Hospital of North Staffordshire is to analyse mothers’ own expressed milk at 10-14 days to determine milk composition (FIGURE 2). This information is used as an assessment tool to meet the recommended protein and energy requirements for preterm infants8. In order to decide if this practice provides delivery of best care, an audit was undertaken between March and October 2011.