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dc.contributorUniversitat Ramon Llull. IQS
dc.contributor.authorOller Salvia, Benjamí
dc.contributor.authorHerranz Barbero, Ana
dc.contributor.authorRico, Nayra
dc.contributor.authorAldecoa-Bilbao, Victoria
dc.contributor.authorMacías-Muñoz, Laura
dc.contributor.authorWijngaard, Robin
dc.contributor.authorFigueras-Aloy, Josep
dc.contributor.authorSalvia-Roigés, Ma Dolors
dc.date.accessioned2021-07-15T09:26:40Z
dc.date.accessioned2023-07-13T05:45:47Z
dc.date.available2021-07-15T09:26:40Z
dc.date.available2023-07-13T05:45:47Z
dc.date.issued2020-06
dc.identifier.urihttp://hdl.handle.net/20.500.14342/1110
dc.description.abstractBackground: Human breast milk (BM) fortification is required to feed preterm newborns with less than 32 weeks of gestation. However, addition of fortifiers increases osmolarity and osmolarity values higher than 450 mOsm/kg may be related to gastrointestinal pathology. Hence, fortifier selection and dosage are key to achieve optimal feeding. Objectives: To compare the effect on osmolality of adding different fortifications, including recently developed formulations, to BM and to study evolution of osmolarity over time in supplemented BM. Methods: Frozen mature BM from 10 healthy mothers of premature newborns was fortified with each of the following human milk fortifiers (HMF): AlmirónFortifier®, NANFM85®, or PreNANFM85®. In addition, fortified BMs were modified with one of the following nutritional supplements (NS): Duocal MCT®, Nutricia® AminoAcids Mix, or Maxijul®. Osmolality of BM alone, fortified and/or supplemented was measured at 1 and 22 hours after their preparation. All samples were kept at 4°C throughout the study. Results: Osmolality of BM alone was close to 300 mOsm/kg and did not change over 22 hours. When equicaloric amounts of HMF AlmirónFortifier®, NANFM85®, and PreNANFM85® were added to BM, osmolality increased roughly to 480 mOsm/kg with the first two fortifiers and only to 433±6 mOsm/kg with the third one. Upon addition of any of four different NSs to BM modified with AlmirónFortifier® and NANFM85®, osmolality reached values greater than 520 mOsm/kg, while osmolality of PreNANFM85® with two out of the four NSs remained below 490 mOsm/kg. NSs supplementing carbohydrates and hydrolysed proteins resulted into a higher increase of BM osmolarity. Osmolality increased significantly with time and, after 22h, only BM modified with PreNANFM85® remained below 450 mOsm/kg. Conclusions: Upon addition of the HMFs tested, BM osmolality increases significantly and keeps raising over time. All HMFs but the recently developed PreNAN FM85® at 4% exceed the AAP recommended threshold for osmolarity of 450 mOsm/kg. Addition of NSs to PreNAN FM85® at 4% significantly increases osmolality above 450 mOsm/Kg. Thus, using PreNAN FM85® at 5% may be preferable to adding nutritional supplements since nutritional recommendations by the ESPGHAN are reached with a lower increase in osmolality.eng
dc.format.extent11 p.cat
dc.language.isoengcat
dc.publisherPublic Library of Sciencecat
dc.relation.ispartofPlos One. Vol.15, n.6 (2020), e0233924cat
dc.rightsAttribution 4.0 International
dc.rights© L'autor/a
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceRECERCAT (Dipòsit de la Recerca de Catalunya)
dc.subject.otherLlet maternacat
dc.subject.otherReflux gastroesofàgiccat
dc.subject.otherInfants prematurscat
dc.subject.otherNecrotizing enterocolitiscat
dc.subject.otherGastroesophageal refluxcat
dc.subject.otherPreterm infantscat
dc.subject.otherProtein contentcat
dc.subject.otherOsmolalitycat
dc.subject.otherFortificationcat
dc.subject.otherMedicationscat
dc.titleFortifier selection and dosage enables control of breast milk osmolaritycat
dc.typeinfo:eu-repo/semantics/articlecat
dc.typeinfo:eu-repo/semantics/publishedVersioncat
dc.rights.accessLevelinfo:eu-repo/semantics/openAccess
dc.embargo.termscapcat
dc.subject.udc612
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0233924cat


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Attribution 4.0 International
Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by/4.0/
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