Human milk bank and personalized nutrition in the NICU: a narrative review
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REVIEW
Human milk bank and personalized nutrition in the NICU: a narrative review Manuel Sánchez Luna 1
&
Sylvia Caballero Martin 1 & Carmen Sánchez Gómez-de-Orgaz 1
Received: 13 October 2020 / Revised: 14 November 2020 / Accepted: 20 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The number of infants born preterm including extremely premature babies is rising worldwide, particularly in low- and middleincome countries, which challenge neonatologists and milk banks for the provision of the most adequate nutrition for successful infant’s growth and development. The benefits of mother’s own milk (MOM) have been extensively recognized, but the use of donor milk (DM) is a commonly routine practice in preterm neonates admitted to the NICU. Pasteurized mature milk from milk banks is not the same composition than the mother’s colostrum and premature milk, the characteristics of which protect the infant from the risk for necrotizing enterocolitis, late-onset sepsis, and other comorbidities associated with prematurity. The development of a personalized nutrition unit (PNU) allows to obtain DM from mothers who have their infants admitted to the NICU and produce an excess of milk, a practice that matches MOM by gestational age and the stage of lactation, ensuring an adequate composition of DM to target the nutritional requirements of premature infants. Conclusion: This narrative review presents salient data of our current knowledge and concerns regarding milk feeding of preterm infants in the NICU, with special emphasis on personalized DM as a result of establishing a PNU. What is Known: • Donor milk bank is mature or pooled milk from lactating mothers at different stages of lactation. • Milk composition varies by gestational age and stage of lactation. What is New: • Donor milk from mothers delivered prematurely have the most adequate composition for preterm infant feeding. • Personalized nutrition for premature infants with preterm donor milk is feasible.
Keywords Donor milk . Milk bank . Personalized nutrition . Prematurity
Abbreviations DM Donor milk IgA Immunoglobulin A
Communicated by Daniele De Luca * Manuel Sánchez Luna [email protected]
HMOs HoP HPP HTST LOS NEC NICU MOM PNU
Human milk oligosaccharides Holder pasteurization High-pressure processing High-temperature short-time Late-onset sepsis Necrotizing enterocolitis Neonatal intensive care unit Mother’s own milk Personalized nutrition unit
Sylvia Caballero Martin [email protected] Carmen Sánchez Gómez-de-Orgaz [email protected] 1
Neonatology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, C/ O’Donnell 48, E-28009 Madrid, Spain
Introduction Every year, an estimated 15 million babies are born preterm and these numbers are rising [1, 2]. Appropriate nutrition is a
Eur J Pediatr
critical factor in efforts to improve survival and outcomes of extremely and very preterm babies [3–5]. The mother’s own milk (MOM) composition differs from mature or
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