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Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants

Fixed-dose fortification of human milk (HM) is insufficient to meet the nutrient requirements of preterm infants. Commercial human milk analyzers (HMA) to individually fortify HM are unavailable in most centers. We describe the development and validation of a bedside color-based tool called the ‘hum...

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Autores principales: Pillai, Anish, Albersheim, Susan, Niknafs, Nikoo, Maugo, Brian, Rasmussen, Betina, Lam, Mei, Grewal, Gurpreet, Albert, Arianne, Elango, Rajavel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146985/
https://www.ncbi.nlm.nih.gov/pubmed/37111084
http://dx.doi.org/10.3390/nu15081866
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author Pillai, Anish
Albersheim, Susan
Niknafs, Nikoo
Maugo, Brian
Rasmussen, Betina
Lam, Mei
Grewal, Gurpreet
Albert, Arianne
Elango, Rajavel
author_facet Pillai, Anish
Albersheim, Susan
Niknafs, Nikoo
Maugo, Brian
Rasmussen, Betina
Lam, Mei
Grewal, Gurpreet
Albert, Arianne
Elango, Rajavel
author_sort Pillai, Anish
collection PubMed
description Fixed-dose fortification of human milk (HM) is insufficient to meet the nutrient requirements of preterm infants. Commercial human milk analyzers (HMA) to individually fortify HM are unavailable in most centers. We describe the development and validation of a bedside color-based tool called the ‘human milk calorie guide’(HMCG) for differentiating low-calorie HM using commercial HMA as the gold standard. Mothers of preterm babies (birth weight ≤ 1500 g or gestation ≤ 34 weeks) were enrolled. The final color tool had nine color shades arranged as three rows of three shades each (rows A, B, and C). We hypothesized that calorie values for HM samples would increase with increasing ‘yellowness’ predictably from row A to C. One hundred thirty-one mother’s own milk (MOM) and 136 donor human milk (DHM) samples (total n = 267) were color matched and analyzed for macronutrients. The HMCG tool performed best in DHM samples for predicting lower calories (<55 kcal/dL) (AUC 0.87 for category A DHM) with modest accuracy for >70 kcal/dL (AUC 0.77 for category C DHM). For MOM, its diagnostic performance was poor. The tool showed good inter-rater reliability (Krippendorff’s alpha = 0.80). The HMCG was reliable in predicting lower calorie ranges for DHM and has the potential for improving donor HM fortification practices.
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spelling pubmed-101469852023-04-29 Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants Pillai, Anish Albersheim, Susan Niknafs, Nikoo Maugo, Brian Rasmussen, Betina Lam, Mei Grewal, Gurpreet Albert, Arianne Elango, Rajavel Nutrients Article Fixed-dose fortification of human milk (HM) is insufficient to meet the nutrient requirements of preterm infants. Commercial human milk analyzers (HMA) to individually fortify HM are unavailable in most centers. We describe the development and validation of a bedside color-based tool called the ‘human milk calorie guide’(HMCG) for differentiating low-calorie HM using commercial HMA as the gold standard. Mothers of preterm babies (birth weight ≤ 1500 g or gestation ≤ 34 weeks) were enrolled. The final color tool had nine color shades arranged as three rows of three shades each (rows A, B, and C). We hypothesized that calorie values for HM samples would increase with increasing ‘yellowness’ predictably from row A to C. One hundred thirty-one mother’s own milk (MOM) and 136 donor human milk (DHM) samples (total n = 267) were color matched and analyzed for macronutrients. The HMCG tool performed best in DHM samples for predicting lower calories (<55 kcal/dL) (AUC 0.87 for category A DHM) with modest accuracy for >70 kcal/dL (AUC 0.77 for category C DHM). For MOM, its diagnostic performance was poor. The tool showed good inter-rater reliability (Krippendorff’s alpha = 0.80). The HMCG was reliable in predicting lower calorie ranges for DHM and has the potential for improving donor HM fortification practices. MDPI 2023-04-13 /pmc/articles/PMC10146985/ /pubmed/37111084 http://dx.doi.org/10.3390/nu15081866 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pillai, Anish
Albersheim, Susan
Niknafs, Nikoo
Maugo, Brian
Rasmussen, Betina
Lam, Mei
Grewal, Gurpreet
Albert, Arianne
Elango, Rajavel
Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants
title Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants
title_full Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants
title_fullStr Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants
title_full_unstemmed Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants
title_short Human Milk Calorie Guide: A Novel Color-Based Tool to Estimate the Calorie Content of Human Milk for Preterm Infants
title_sort human milk calorie guide: a novel color-based tool to estimate the calorie content of human milk for preterm infants
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146985/
https://www.ncbi.nlm.nih.gov/pubmed/37111084
http://dx.doi.org/10.3390/nu15081866
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