Limitations in clinical application of rapid measurements of macronutrients in human milk

Abstract

Rapid measurements of macronutrients in human milk by infrared spectroscopy, particularly widely used mid-infrared at bed side, is undergoing rapid development in recent years. A recent published systematic review showed that the accurate rate of infrared spectroscopy for protein and fat measurement was only between 60% and 70%, while for carbohydrate/lactose was inconclusive. As for domestic used digital ultrasound techniques, only few studies were published based on small sample size and thus it is difficult to evaluate the results. The storage, temperature and container for milk samples may also affect the results. As individual human milk contents vary during the whole lactation period resulting in the instability of all contents, one single or few samples might not be representative. The proposed individualized fortification based on rapid measurement of human milk has failed to ensure a better growth though it might be true that the analysis made less error in determining the volume of fortifier. We concluded that routine clinical use of bedside or rapid measurement of human milk contents still lack of evidence and should not be recommended. Key words: Milk, human; Proteins; Carbohydrates; Spectrophotometry