Fortification of human milk (HM) is a standard practice for feeding very low birth weight infants (VLBWI). VLBWI often have growth deficiency and feeding intolerance (FI). Due the biochemical similarity of donkey milk (DM) to HM, a new DM-derived fortifier (DF) was developed. A clinical trial was recently performed, aimed at comparing the effects of HM fortification with DF to HM fortification with commercial bovine milk-derived fortifier (BF), in VLBWI. DF resulted to reduce FI, bilious gastric residuals and vomiting episodes with respect to BF. The aim of the present work was to assess whether the different types of fortification affect the digestive kinetics of HM macronutrients during in vitro dynamic digestion. Preterm HM milk samples fortified either with DF or with BF, at isoproteic and isocaloric conditions, were digested in vitro using preterm gastrointestinal conditions. Samples were collected at different digestion times and were characterized for their particle size distribution, confocal microscopy and protein profiles (SDS-PAGE). Large particles were found in HM+DF before and during the initial gastric digestion, with particles being disintegrated only after 60 min of gastric digestion. In the intestinal phase, the evolution of the particle sizes was rather similar between HM+DF and HM+BF. During the entire digestion, similar protein hydrolysis was observed for the two fortified milks. In particular, caseins were hydrolyzed at the end of the gastric phase, unlike whey proteins, which were mostly digested in the intestinal phase. Despite the two fortifiers greatly differed in terms of protein structure (extensively hydrolyzed for HM+DF vs. whole proteins for HM+BF), we found a similar HM protein digestion in the two types of milk. A possible role of the higher particle size found in the HM+DF in the reduction of the FI episodes observed in the clinical trial is discussed.
Impact of a novel human milk fortifier from donkey milk on the kinetic of human milk macronutrients digestion after in vitro dynamic digestion
Nebbia S;Giribaldi M;Cavallarin L;
2019
Abstract
Fortification of human milk (HM) is a standard practice for feeding very low birth weight infants (VLBWI). VLBWI often have growth deficiency and feeding intolerance (FI). Due the biochemical similarity of donkey milk (DM) to HM, a new DM-derived fortifier (DF) was developed. A clinical trial was recently performed, aimed at comparing the effects of HM fortification with DF to HM fortification with commercial bovine milk-derived fortifier (BF), in VLBWI. DF resulted to reduce FI, bilious gastric residuals and vomiting episodes with respect to BF. The aim of the present work was to assess whether the different types of fortification affect the digestive kinetics of HM macronutrients during in vitro dynamic digestion. Preterm HM milk samples fortified either with DF or with BF, at isoproteic and isocaloric conditions, were digested in vitro using preterm gastrointestinal conditions. Samples were collected at different digestion times and were characterized for their particle size distribution, confocal microscopy and protein profiles (SDS-PAGE). Large particles were found in HM+DF before and during the initial gastric digestion, with particles being disintegrated only after 60 min of gastric digestion. In the intestinal phase, the evolution of the particle sizes was rather similar between HM+DF and HM+BF. During the entire digestion, similar protein hydrolysis was observed for the two fortified milks. In particular, caseins were hydrolyzed at the end of the gastric phase, unlike whey proteins, which were mostly digested in the intestinal phase. Despite the two fortifiers greatly differed in terms of protein structure (extensively hydrolyzed for HM+DF vs. whole proteins for HM+BF), we found a similar HM protein digestion in the two types of milk. A possible role of the higher particle size found in the HM+DF in the reduction of the FI episodes observed in the clinical trial is discussed.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
