title: Human Milk for Ill and Medically Compromised Infants: Strategies and Ongoing Innovation.
abstract: The use of human milk (mother's own milk and/or donor milk) in ill or medically compromised infants frequently requires some adaptation to address medical diagnoses and/or altered nutrition requirements. This tutorial describes the nutrition and immunological benefits of breast milk as well as provides evidence for the use of donor milk when mother's own milk is unavailable. Several strategies used to modify human milk to meet the medical and nutrition needs of an ill or medically compromised infant are reviewed. These strategies include (1) the standard fortification of human milk to support adequate growth, (2) the novel concept of target fortification in preterm infants, (3) instructions on how to alter maternal diet to address cow's milk protein intolerance and/or allergy in breast milk-fed infants, and (4) the removal and modification of the fat in breast milk used in infants diagnosed with chylothorax.
authors.affiliation: Department of Nutritional Sciences, University of Toronto, Toronto, Canada Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Canada The Research Institute, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Sara
authors.initials: S
authors.lastname: DiLauro
authors.affiliation: Department of Paediatrics, University of Toronto, Toronto, Canada Rogers Hixon Ontario Human Milk Bank, Mount Sinai Hospital, Toronto, Canada Department of Paediatrics, Mount Sinai Hospital, Toronto, Canada Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Sharon
authors.initials: S
authors.lastname: Unger
authors.affiliation: Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Canada Rogers Hixon Ontario Human Milk Bank, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Debbie
authors.initials: D
authors.lastname: Stone
authors.affiliation: Department of Nutritional Sciences, University of Toronto, Toronto, Canada The Research Institute, The Hospital for Sick Children, Toronto, Canada deborah.oconnor@utoronto.ca.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: O'Connor
mesh_terms: D000818:Animals; D002417:Cattle; D005512:Food Hypersensitivity; D005527:Food, Fortified; D006801:Humans; D007109:Immunity; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy; D007234:Infant, Premature / Q000254:growth & development; D008894:Milk Proteins / Q000276:immunology; D008895:Milk, Human / Q000737:chemistry; D009751:Nutritional Requirements; D009753:Nutritive Value; D014019:Tissue Donors
chemical_list: D008894:Milk Proteins
keywords: breast milk; human milk; infant; nutrition