A fortifier comprising protein, vitamins, and calcium-glycerophosphate for preterm human milk.
BACKGROUND
The infant's own mother's milk, fortified with proteins, minerals, and vitamins, is considered the best food for low-birth-weight infants. This paper describes the process to obtain a liquid human milk fortifier.


METHODS
The fortifier comprises a protein concentrate, calcium, phosphate, and zinc salts, as well as vitamins A and D. A powdered whey protein extracted from bovine milk was concentrated from 31.5-76.8 g/100 g using repetitive dialysis. The protein concentrate was dissolved in a 0.2 M phosphate buffer pH 7.4 and mixed with calcium-glycerophosphate and calcium-gluconate, vitamins A and D, folic acid, and zinc. Each 10 mL of this liquid fortifier has 0.78 g protein, 53 mg calcium, 36 mg phosphate, and 0.93 mg zinc.


RESULTS
Repetitive dialysis did not modify the protein structure as demonstrated by electrophoresis. A total of 95% of lactose content was discarded. Enriching human milk using this human milk fortifier increased the concentration per deciliter of all added nutrients; proteins increased from 1.68-2.35 g, calcium from 26-90 mg, and phosphorus, from 15-51 mg.


CONCLUSIONS
A liquid human milk fortifier was successfully manufactured using a noncomplex procedure. An intake of 180-200 mL/kg/day of the fortified human milk by the premature infant would satisfy the infant's nutritional requirements and achieve expected growth and development.
Unidad de Investigación Médica en Nutrición, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.
V M
VM
Sánchez-Hidalgo
S
S
Flores-Huerta
G
G
Matute-González
B
B
Urquieta-Aguila
M
M
Bernabe-García
I E
IE
Cisneros-Silva
D002125:Calcium Gluconate / Q000008:administration & dosage; D002626:Chemistry, Pharmaceutical / Q000379:methods; D002762:Cholecalciferol / Q000008:administration & dosage; D003956:Dialysis; D004044:Dietary Proteins / Q000008:administration & dosage*; D004224:Diterpenes; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D005527:Food, Fortified; D005994:Glycerophosphates / Q000008:administration & dosage*; D006801:Humans; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D008895:Milk, Human; D009751:Nutritional Requirements; D010710:Phosphates / Q000008:administration & dosage; D000084562:Retinyl Esters; D014801:Vitamin A / Q000008:administration & dosage / Q000031:analogs & derivatives*; D014815:Vitamins / Q000008:administration & dosage*; D019287:Zinc Sulfate / Q000008:administration & dosage
D004044:Dietary Proteins; D004224:Diterpenes; D005994:Glycerophosphates; D010710:Phosphates; D000084562:Retinyl Esters; D014815:Vitamins; D014801:Vitamin A; D002762:Cholecalciferol; C009166:retinol acetate; D019287:Zinc Sulfate; D005492:Folic Acid; C018279:sodium phosphate; D002125:Calcium Gluconate