Macronutrient content of pooled donor human milk before and after Holder pasteurization

Background: Donor human milk (DHM) is the best alternative for preterm infants when their own mother's milk is unavailable. DHM should be pasteurized to guarantee microbiological safety; however, this process can influence the macronutrient content. The aim of this study was to investigate the effect of Holder pasteurization (HoP) on DHM macronutrient content. Methods: Protein, lactose, lipids (g/100ml) and energy (kcal/100ml) of DHM pools were analysed before and after HoP (62.5 degrees C for 30min) using mid-infrared spectroscopy (HM analyser Miris AB (R)). The mean macronutrient content before and after HoP was compared by paired t-test. The percentage decreases (Delta%) were calculated. Results The change in macronutrient content of 460 pools was determined. Protein, lipids and lactose decreased significantly after HoP (0.880.20 vs 0.86 +/- 0.20 and 2.91 +/- 0.89 vs 2.75 +/- 0.84 and 7.19 +/- 0.41 vs 7.11 +/- 0.48 respectively). The Delta% values were -2.51 +/- 13.12, -4.79 +/- 9.47 and -0.92 +/- 5.92 for protein, lipids and lactose, respectively (p <= 0.001). Conclusion: This study confirms that the macronutrient content of DHM, especially in terms of lipids and protein, is reduced after HoP. Therefore, in order to perform a tailored fortification of DHM, the clinicians need to be aware of the somewhat diminished nutrient content of DHM.