ARS | Publication request: FATTY ACID SOAPS MAY BE RESPONSIBLE FOR POOR FAT ABSORPTION IN PREMATURE INFANTS FED FORTIFIED HUMAN MILK (FHM)

Submitted to: Pediatric Research
Publication Type: Abstract Only
Publication Acceptance Date: February 19, 1999
Publication Date: N/A

Technical Abstract: Although mineral supplementation of human milk for premature infants is recognized, we have shown that infants receiving FHM (mother's own milk plus human milk fortifier),have significantly lower fat absorption than similar infants fed preterm formula (PF) Objective: to determine whether the addition of fortifier reduced fat absorption by promoting the binding of minerals to fatty acids over time. We measured the content of total fat free fatty acids (FFA), and mineral-bound fatty acids (MBFA) in the milk and in the feces of premature infants, 26 to 29wk gestation. Milk was collected by electric breast pumps directly into glass bottles for storage at -20 degrees C. After thawing in warm water for 30 min, 0, 2, or 4 packets of fortifier were added to 100ml of milk, which was then stored at 4 degrees C for 24h. Feces were collected for 72h into plastic bags adherent to the buttocks at 6 to 9wk from premature infants fed either FHM or PF. To determine, by difference, the quantity of fecal MBFA, fecal analyses were repeated without the usual addition of acid. Although milk stored at -20 degrees C had 30% FFA, there were no differences in milk FFA over time. Significant differences in FFA, %MBFA, and Ca were noted between unfortified and FHM. Fecal fat was significantly greater in infants (n=36) fed FHM (5.7+/-0.4 g/100g) than those(n=34) fed PF (3.1+/-0.2 g/100g), p <0.001. Fecal MBFA were significantly greater in infants fed FHM vs PF, 2.4+/-0.2 vs 1.3+/-0.1 g/100g, respectively. In conclusion, we found that there was no change in the total fat, FFA, and Ca content of milk as used under routine nursery conditions for 24 h. However, there was a rapid decrease in milk FFA after fortification, which was significantly associated with the amount of fortifier added.