The nutritional content of human milk changes over time and differs between mothers. Fortifying blindly, without knowing the milk’s macronutrient content, more often than not misses the nutritional target, leaving the infant at risk of over- or undernutrition.

Miris Human Milk Analyzer™ gives the energy, fat, carbohydrate and protein content in human milk within minutes using a small sample volume. This enables clinicians to adapt fortification to the actual macronutrient content of the milk. 

5 reasons to use target fortification

Overcome macronutrient variability in breast milk

There are large variations in the macronutrient content of human milk used in neonatal care. Mother to mother variation, stage of lactation, and methods of storage and treatment can all affect composition. Target fortification is used to tailor human milk for the individual preterm infant’s nutritional needs by analysing the milk prior to fortification. By knowing the macronutrient composition of human milk it becomes easy to identify if fortification is needed.
 

Facilitate quality of growth

Target fortification allows for the monitoring of protein intake and of the protein:energy ratio in the range of nutritional recommendations. This facilitates the right growth for each preterm baby.

Limit the risk of protein deficiency

The concentration of protein in human milk declines significantly after birth. The ESPGHAN 2010 guidelines indicate that most preterm babies have a protein deficit that is linked to their weight and to the composition of their feed. Measuring the protein concentration makes it possible to fortify the milk with the adequate amount required for each baby.
 

Focus on better clinical outcomes

Research indicate that malnutrition leads to a higher prevalence of heart disease in adulthood and has a negative effect om cognitive development. Using target fortification will limit the risk for malnutrition, in the short term associated with poor growth and in the long term with complications such as visual impairment, developmental disorder or cardiovascular disease, or overnutrition resulting in increased body fat, larger waist circumference or impaired glucose homeostasis.

Individualise nutrition to meet each baby's needs

The approach of target fortification, will reduce the variability in nutritional intakes compared to standard fortification, to give each baby the best possible start in life. 

References/Publications

Through years of experience Miris has developed a portfolio of instruments and consumables that are tailored to ensure that the complete workflow related to analysis of breast milk is optimised to provide the most accurate and reproducible results. Our solution includes Miris Human Milk Analyzer for analysis, Miris Ultrasonic Processor and Miris Heater for optimising sample preparation, a range of consumables such as a cleaning solution, control solutions, and tubes, syringes and bottles. Separate service packages are also available.

References  

• Effects of Targeted Versus Adjustable Protein Fortification of Breast Milk on Early Growth in Very Low‐Birth‐Weight Preterm Infants: A Randomized Clinical Trial. Ozgul Bulut MD, Asuman Coban, Ozan Uzunhan MD, Zeynep Ince.
• The Effect of Human Milk on Modulating the Quality of Growth in Preterm Infants. Piemontese P, Liotto N, Mallardi D, Roggero P, Puricelli V, Giannì ML, Morniroli D, Tabasso C, Perrone M, Menis C, Orsi A, Amato O, Mosca F.
• The fortification method relying on assumed human milk composition overestimates the actual energy and macronutrient intakes in very preterm infants. Macedo I, Pereira-da-Silva L, Cardoso M.
• Is targeted fortification of human breast milk an optimal nutrition strategy for preterm infants? An interventional study. Morlacchi L, Mallardi D, Giannì ML, Roggero P, Amato O, Piemontese P, Consonni D, Mosca F.
• Target fortification of breast milk: levels of fat, protein or lactose are not related. Fusch G, Mitra S, Rochow N, Fusch C.
• Target fortification of breast milk with fat, protein, and carbohydrates for preterm infants. Rochow N, Fusch G, Choi A, Chessell L, Elliott L, McDonald K, Kuiper E, Purcha M, Turner S, Chan E, Xia MY, Fusch C.

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