title: Milk osmolality: does it matter?
abstract: High osmolality of infant feed reflects a high concentration of solute particles and has been implicated as a cause of necrotising enterocolitis. Evidence for direct intestinal mucosal injury as a result of hyperosmolar feeds is scant, and no good evidence has been found to support such an association. High osmolality of enteral substrate may, however, slow down gastric emptying. Osmolality of current infant feeds ranges from around 300 mOsm/kg in human breast milk to just more than 400 mOsm/kg in fully fortified breast milk. Addition of mineral and vitamin supplements to small volumes of milk can increase osmolality significantly and should be avoided if possible.
authors.affiliation: Department of Neonatal Medicine, Southampton University Hospitals Trust, Mailpoint 105, Princess Anne Hospital, Coxford Road, Southampton SO16 5YA, UK. freya.pearson@suht.swest.nhs.uk
authors.forename: Freya
authors.initials: F
authors.lastname: Pearson
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Johnson
authors.forename: Alison A
authors.initials: AA
authors.lastname: Leaf
mesh_terms: D000818:Animals; D020345:Enterocolitis, Necrotizing / Q000209:etiology*; D041981:Gastrointestinal Tract / Q000254:growth & development; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000737:chemistry; D007231:Infant, Newborn; D008892:Milk / Q000009:adverse effects / Q000737:chemistry*; D008895:Milk, Human / Q000737:chemistry; D009994:Osmolar Concentration