Formula for the progressive reintroduction of fat into breast milk in infants with chylothorax

Chylothorax in infants is a potentially life-threatening condition, often resulting from injury during cardiac surgery. Traditionally, breastfeeding is discontinued. Recently, feeding with defatted human milk has been safely introduced. However, methods for fat reintroduction are not standardized. We developed a mathematical formula to facilitate individualized, progressive reintroduction of fat into skimmed breast milk. Fat and protein content were analyzed by Fourier-transform infrared spectroscopy (FTIR). Defatting was performed by centrifugation at 3000 rpm at 2°C for 15 min. The formula considers: fat concentration of unmodified human milk and defatted milk, target fat concentration, and milk volume. Clinical application in a premature infant showed effective fat reintroduction (0.2 g/dL every 48 h), with no recurrence of chylothorax. Some factors influenced milk defatting. Breast milk provides important immunological and functional benefits. Our formula supports safe administration and can assist in designing further studies to determine optimal daily fat increments.