title: Effect of fortification on the osmolality of human milk.
abstract: OBJECTIVE
  To evaluate the effect of fortification on the osmolality of human milk.
  
  
  METHODS
  The 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 degrees C.
  
  
  RESULTS
  Ten 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.
  
  
  CONCLUSIONS
  Human 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.
authors.affiliation: University of Liège Hôpital de la Citadelle CHR Citadelle 4000 Liège Belgium.
authors.forename: M
authors.initials: M
authors.lastname: De Curtis
authors.forename: M
authors.initials: M
authors.lastname: Candusso
authors.forename: C
authors.initials: C
authors.lastname: Pieltain
authors.forename: J
authors.initials: J
authors.lastname: Rigo
mesh_terms: D003912:Dextrins / Q000032:analysis; D005519:Food Preservation; D005527:Food, Fortified / Q000032:analysis*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D016014:Linear Models; D008895:Milk, Human / Q000737:chemistry*; D009994:Osmolar Concentration
chemical_list: D003912:Dextrins