title: Target fortification of breast milk: levels of fat, protein or lactose are not related.
abstract: OBJECTIVE
  Target fortification (TFO) of breast milk has the potential to improve the nutritional outcomes of preterm infants. However, the primary logistic constraint in introducing TFO is analysers that rapidly and accurately analyse macronutrients (fat, protein and lactose). In this prospective observational study, we aim to evaluate whether the levels of fat, protein and carbohydrate could be predicted from one key macronutrient.
  
  
  METHODS
  Macronutrient components were measured in 543 breast milk samples using validated chemical micro-methods. Correlation analysis for fat versus protein, fat versus lactose and lactose versus protein was computed using Pearson's correlation.
  
  
  RESULTS
  The concentration of the macronutrients ranged from 0.7 to 10.3 g/100 mL (3.7 ± 1.2, mean ± SD) for fat, 0.7 to 3.2 g/100 mL (1.3 ± 0.3) for protein and 4.0 to 8.8 g/100 mL (5.8 ± 0.7) for lactose, respectively. There was no correlation between the three macronutrients.
  
  
  CONCLUSIONS
  This lack of correlation underlines the importance of routine and accurate analysis of all three macronutrients in breast milk prior to TFO.
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Fusch
authors.forename: Souvik
authors.initials: S
authors.lastname: Mitra
authors.forename: Niels
authors.initials: N
authors.lastname: Rochow
authors.forename: Christoph
authors.initials: C
authors.lastname: Fusch
mesh_terms: D005223:Fats / Q000032:analysis*; D005260:Female; D006801:Humans; D007785:Lactose / Q000032:analysis*; D008895:Milk, Human / Q000737:chemistry*; D011247:Pregnancy; D011446:Prospective Studies; D011506:Proteins / Q000032:analysis*
chemical_list: D005223:Fats; D011506:Proteins; D007785:Lactose
keywords: Expressed breast milk; Micro-methods; Preterm; Target fortification