Evaluation of fat separation and removal methods to prepare low-fat breast milk for fat-intolerant neonates with chylothorax.
BACKGROUND
The purpose of this study was to compare 2 methods (syringe and spoon methods) of removing the fat from the low-fat milk portion and compare 3 methods (refrigerated centrifuge, nonrefrigerated centrifuge, and refrigeration method) of separating breast milk into the fat and low-fat milk components.


METHODS
Human milk was divided into 24 aliquots using the 3 separating methods, and 2 methods (syringe, spoon) were compared to extract the low-fat milk. Thirty-one human milk samples were separated into fatty and low-fat milk layers using 3 methods: 24-hour refrigerator storage (2°C), centrifuged at 3000 rpm for 15 minutes at room temperature, and spun in the refrigerated-centrifuge at 3000 rpm for 15 minutes at 2°C. After 24 hours of refrigeration, a syringe was used to remove the low-fat milk. Triglycerides were analyzed before and after separation and removal methods.


RESULTS
For fat removal, the syringe method (1.2 g/dl, 95% confidence interval [CI], 1.1-1.4, fat content) left 34% less residual fat compared to the spoon method (1.9 g/dl, 95% CI, 1.5-2.3); this difference did not reach statistical significance (P = .065). For fat separation, the centrifuge methods (mean: 1.0 g/dl, 95% CI, 0.8-1.1) left significantly less residual fat than the refrigerator method (3.4 g/dl, 95% CI, 3.0-3.7; P < .0001).


CONCLUSIONS
Using the syringe vs a spoon at removing the milk from the fat, although not statistically significant, was likely of clinical importance. A centrifuge was more effective at separating the fat in human milk.
Michelle A. Drewniak, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta T3B 6A8, Canada. Email: michelle.drewniak@albertahealthservices.ca.
Michelle A
MA
Drewniak
Andrew W
AW
Lyon
Tanis R
TR
Fenton
D002498:Centrifugation; D002916:Chylothorax / Q000178:diet therapy*; D005223:Fats / Q000032:analysis*; D005227:Fatty Acids / Q000032:analysis*; D005260:Female; D005511:Food Handling / Q000379:methods*; D006801:Humans; D008895:Milk, Human / Q000737:chemistry*; D012034:Refrigeration
D005223:Fats; D005227:Fatty Acids
chyle; chylothorax; dietary fats; human milk; infant; milk fat globule