title: Assessment of human milk composition using mid-infrared analyzers requires calibration adjustment.
abstract: Nutrient composition of human milk (HM) is highly variable. Targeted HM fortification has been proposed to address these variations and reduce the cumulative nutritional deficit in preterm infants. Near-infrared analysis is used to measure the protein and fat content in HM; however, the reliability of this technique has not been evaluated. The objective of this study is to evaluate the reproducibility and accuracy of two generations of HM analyzers (HMA1 and HMA2) in estimating protein and lipid contents.
  
  
  
  Reproducibility was assessed by analyzing in duplicate 146 and 128 HM samples with HMA1 and HMA2 (Miris), respectively. To evaluate the accuracy, lipid and protein concentrations were assessed in 31 and 39 samples using HMA1 or HMA2, respectively. Values were compared with measurements obtained using reference methods and correction equations were calculated. After applying the correction equations on 12 HM samples, the performance of the two devices were compared and the equation was validated according to the reference methods.
  
  
  
  The coefficients of variation for protein and lipid assessments were below 3% for both HMA1 and HMA2. Protein concentrations were significantly underestimated by HMA2 (-0.53±0.23 g dl-1). Lipid content was significantly overestimated by both devices, but the error was greater with HMA1 (0.76±0.48 g dl-1) than with HMA2 (0.36±0.33 g dl-1). Correction equations were specific for each generation of HMA. Finally, after correction, both instruments provided similar and accurate results.
  
  
  
  HMAs require calibration adjustment before their use in clinical practice, to avoid inappropriate HM fortification.
authors.affiliation: Hospices Civils de Lyon, Service de Néonatologie, Hôpital de la Croix Rousse, Lyon, France.|Lactarium Regional Rhône-Alpes, Hôpital de la Croix Rousse, Lyon, France.
authors.forename: R
authors.initials: R
authors.lastname: Buffin
authors.affiliation: Hospices Civils de Lyon, Pole IMER, Unité de Recherche Clinique, Lyon, France.|Université Claude Bernard Lyon 1, EA Santé-Individu-Société, Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Decullier
authors.affiliation: Department of Neonatology, CHR de la Citadelle, Liège, Belgium.
authors.forename: V
authors.initials: V
authors.lastname: De Halleux
authors.affiliation: Hospices Civils de Lyon, Service de Néonatologie, Hôpital de la Croix Rousse, Lyon, France.|Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Merieux, Pierre Bénite, France.
authors.forename: C-M
authors.initials: CM
authors.lastname: Loys
authors.affiliation: Hospices Civils de Lyon, Service de Néonatologie, Hôpital de la Croix Rousse, Lyon, France.|Centre de Recherche en Nutrition Humaine Rhône-Alpes, Hôpital Lyon Sud, Pierre Bénite, France.
authors.forename: S
authors.initials: S
authors.lastname: Hays
authors.affiliation: Department of Neonatology, CHR de la Citadelle, Liège, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: Studzinsky
authors.affiliation: Hospices Civils de Lyon, Service de Néonatologie, Hôpital de la Croix Rousse, Lyon, France.|Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Merieux, Pierre Bénite, France.
authors.forename: E
authors.initials: E
authors.lastname: Jourdes
authors.affiliation: Department of Neonatology, CHR de la Citadelle, Liège, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Rigo
authors.affiliation: Hospices Civils de Lyon, Service de Néonatologie, Hôpital de la Croix Rousse, Lyon, France.|Lactarium Regional Rhône-Alpes, Hôpital de la Croix Rousse, Lyon, France.|Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Merieux, Pierre Bénite, France.|Centre de Recherche en Nutrition Humaine Rhône-Alpes, Hôpital Lyon Sud, Pierre Bénite, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Picaud
mesh_terms: D002138:Calibration / Q000592:standards; D004041:Dietary Fats / Q000032:analysis*; D005602:France; D006801:Humans; D016014:Linear Models; D008894:Milk Proteins / Q000032:analysis*; D008895:Milk, Human / Q000737:chemistry*; D015203:Reproducibility of Results; D019265:Spectroscopy, Near-Infrared / Q000592:standards*
chemical_list: D004041:Dietary Fats; D008894:Milk Proteins