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The Effects of Fortification and Refrigerated Storage on Bioactive Proteins in Holder-pasteurized Donor Human Milk

Schlotterer, Hannah R.*; Parvez, Boriana; Perrin, Maryanne T.*

Journal of Pediatric Gastroenterology and Nutrition: May 9, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPG.0000000000002386
Original Article: Nutrition: PDF Only
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Objective: The aim of the study was to assess the total protein, lysozyme, and immunoglobulin A (IgA) content of unfortified and fortified Holder-pasteurized donor human milk (HPDHM) during 96 hours of refrigerated storage.

Study Design: HPDHM was prepared in a hospital feeding room and subjected to treatment with 3 different fortifiers: an acidic, bovine-based (F-ACID), a neutral, bovine-based, and a human milk–derived (F-HUM) fortifier. Unfortified HPDHM served as the control (CONTROL). Samples were stored at 4°C, and every 24 hours, a 1-mL aliquot was removed for analysis.

Results: At baseline, there was a significant difference in protein (mean, standard deviation) concentration (g/dL) between control (1.3, 0.1) and all other treatments (F-ACID = 2.0, 0.2; neutral, bovine-derived fortifier = 2.2, 0.1; F-HUM = 2.5, 0.1; P < 0.001). Lysozyme and IgA were significantly lower in the F-ACID group (P < 0.001). Lysozyme and IgA were significantly higher in the F-HUM group (P < 0.001). There was no significant effect of storage time (P > 0.9) for all dependent variables.

Conclusion: The type of fortifier has a more significant impact on bioactive components in fortified HPDHM than does storage time. Our findings of lack of negative impact of refrigeration storage time on the protein and bioactive components of donor milk strengthen the recent recommendations to extend storage time to 48 hours.

*Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC

Division of Neonatology, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY.

Address correspondence and reprint requests to Maryanne T. Perrin, PhD, University of North Carolina Greensboro, 319 College Ave, 318 Stone, Greensboro, NC 27412 (e-mail: mtperrin@uncg.edu).

Received 25 February, 2019

Accepted 14 April, 2019

This research received financial support from the University of North Carolina Greensboro Health and Human Science Research Excellence award, and from the University of North Carolina Greensboro Faculty First Summer Scholarship award to M.T.P.

M.T.P. serves on the Board of Directors for the Human Milk Banking Association of North America in an unpaid capacity. B.P. serves on the Research Committee of the Human Milk Banking Association of North America in an unpaid capacity and on the Board of Directors of The New York Milk Bank. H.R.S. reports no conflicts of interest.

The authors report no conflicts of interest

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,