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Minerals and trace elements in pasteurized donor human milk: Implications for infants born preterm and term
Megan R Beggs1, Shachar Shalit2, Kate Patton3
1Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Clinical Nutrition ESPEN
|July 10, 2026
Summary
Pasteurized donor human milk (PDHM) fortified for premature infants may not provide adequate sodium and zinc. Further research is needed to understand the implications of varying mineral and trace element levels in PDHM for infant nutrition.
Area of Science:
- Neonatal nutrition
- Pediatric mineral metabolism
Background:
- Mother's own milk (MOM) is ideal for infants, but pasteurized donor human milk (PDHM) is used for preterm, very low birthweight (VLBW) infants.
- Human milk fortifiers (HMFs) are added to PDHM for VLBW infants due to their high nutrient needs.
- Limited data exists on the mineral adequacy of PDHM for VLBW infants.
Purpose of the Study:
- To determine mineral and trace element concentrations in PDHM.
- To compare these concentrations to expert recommendations for VLBW infants.
- To compare PDHM mineral content to reference values for term-born infants.
Main Methods:
- Analyzed 196 batches of pooled PDHM for 10 elements (Na, K, Ca, P, Mg, Zn, Cu, I, Mn, Fe) using ICP-MS.
- Calculated enteral element intake using six HMFs and one preterm formula at 160 mL/kg/day.
- Compared intakes to European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines and reference values.
Main Results:
- PDHM with most HMFs did not meet ESPGHAN recommended intakes for sodium and zinc for VLBW infants.
- Copper intake may be low; manganese and iodine may exceed recommendations, depending on the HMF.
- All measured elements, except copper, differed significantly from reference values for term-born infants.
Conclusions:
- Fortified PDHM may lead to suboptimal element intake in preterm VLBW infants.
- Findings offer insights for clinicians feeding PDHM to both preterm and term-born infants.
- The clinical significance of element levels outside recommended ranges requires further investigation.
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