Pooling Strategies to Modify Macronutrient Content of Pasteurized Donor Human Milk

Area of Science:

• Neonatal Nutrition
• Human Milk Composition
• Infant Feeding Practices

Background:

• Donor human milk (DHM) is crucial for preterm infants when mother's own milk is unavailable.
• Variability in DHM macronutrient content poses challenges for meeting preterm infant nutritional needs.
• Pooling strategies can standardize DHM macronutrient composition.

Purpose of the Study:

• To compare random pooling (RP) and target pooling (TP) strategies for DHM.
• To assess how pooling strategies affect DHM macronutrient content.
• To determine optimal RP practices for achieving target macronutrient levels.

Main Methods:

• Analysis of macronutrient content in 1,169 single-donor milk samples.
• Simulation of 10,000 randomly selected pools with varying donor numbers (2-5) and volumes.
• Comparison of macronutrient content against reference values for human milk.

Main Results:

• Increasing the number of donors per pool consistently improved macronutrient content, regardless of pooling strategy.
• Both RP and TP strategies showed improved macronutrient content with more donors.
• A TP strategy was simulated to achieve specific macronutrient targets.

Conclusions:

• Pooling DHM enhances macronutrient content, aiding preterm infant nutrition.
• When TP is not feasible, RP involving at least five donors is recommended.
• Optimizing DHM pooling is vital for ensuring adequate preterm infant growth and development.