Maryanne T Perrin1, Erin Hamilton Spence2, Mandy B Belfort3, Margaret G Parker4, Lars Bode5. 1. Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, USA. mtperrin@uncg.edu. 2. Mothers Milk Bank of North Texas, Fort Worth, TX, USA. 3. Department of Pediatric Newborn Medicine; Brigham Women's Hospital and Harvard Medical School, Boston, MA, USA. 4. Department of Pediatrics; Boston Medical Center; Boston University School of Medicine, Boston, MA, USA. 5. Department of Pediatrics, University of California, San Diego, San Diego, CA, USA.
Abstract
OBJECTIVE: Energy values for human milk are increasingly available clinically, though there are no standards for deriving these values. We compared published calorie methods using a common set of samples. STUDY DESIGN: Ten human milk samples were measured for gross and digestible macronutrients using laboratory methods. Four calorie conversion factors were used: Atwater general (ATW-GEN); Atwater milk specific (ATW-MILK), human milk specific (HUM-MILK), and combustible conversions (COMBUST). Differences in derived calories were assessed using ANOVA. RESULTS: There was a significant difference (P < 0.001) in calorie values between methods. Gross macronutrients with COMBUST conversion factors produced the highest calorie values (19.4 ± 1.4 kcal/ounce) whereas digestible macronutrients with HUM-MILK conversion factors produced the lowest calorie values (16.3 ± 1.3 kcal/ounce). Mean difference between these values was 3.1 kcal/ounce (95% CI 2.5, 3.7). CONCLUSION: Mean calorie difference of 3.1 kcal/ounce is clinically important for preterm infants, suggesting the need for standardization.
OBJECTIVE: Energy values for human milk are increasingly available clinically, though there are no standards for deriving these values. We compared published calorie methods using a common set of samples. STUDY DESIGN: Ten human milk samples were measured for gross and digestible macronutrients using laboratory methods. Four calorie conversion factors were used: Atwater general (ATW-GEN); Atwater milk specific (ATW-MILK), human milk specific (HUM-MILK), and combustible conversions (COMBUST). Differences in derived calories were assessed using ANOVA. RESULTS: There was a significant difference (P < 0.001) in calorie values between methods. Gross macronutrients with COMBUST conversion factors produced the highest calorie values (19.4 ± 1.4 kcal/ounce) whereas digestible macronutrients with HUM-MILK conversion factors produced the lowest calorie values (16.3 ± 1.3 kcal/ounce). Mean difference between these values was 3.1 kcal/ounce (95% CI 2.5, 3.7). CONCLUSION: Mean calorie difference of 3.1 kcal/ounce is clinically important for preterm infants, suggesting the need for standardization.
Authors: Elisabeth Stoltz Sjöström; Inger Öhlund; Fredrik Ahlsson; Eva Engström; Vineta Fellman; Ann Hellström; Karin Källén; Mikael Norman; Elisabeth Olhager; Fredrik Serenius; Magnus Domellöf Journal: Acta Paediatr Date: 2013-08-06 Impact factor: 2.299