Creamatocrit-based breast milk supplementation among the preterm, is there a need?

ABSTRACT

To detect the accuracy of creamatocrit [CRCT] technique, to detect variability in lipid and caloric content of the breast milk of mothers of preterm [BM'pr] and to assess the need for supplementation of BM'pr. Creamatocrit [CRCT] of BM-pr was measured prospectively among mothers of 38 preterm and 38 term neonates within the first 2 weeks. CRCF was measured [Fresh foremilk. hind-milk, composite milk]. Lipid and Caloric contents were also measured using volumetric [Gerber Method] and calorimetry respectively. T-test and chi square were used to detect difference between preterm and term values. Regression analysis for the relationship between CRCT and laboratory fat and caloric contents was conducted. Linear regression equations were used for fat and caloric estimation. Mean CRCT among preterm was 5.15 +/- 1.4%, mean Lipid and caloric concentration were 34.73 +/- 11.65 g/L and 507.5 +/- 86.31 Kcal/L respectively. Compared to 9.34 +/- 2.1%, 56.4 +/- 9.3 g/L and 880.02 +/- 88.01 kcal/L among term respectively, p<0.0001 for all differences. Hind milk values for CRCT, Lipids and calories were statistically higher than foremilk. p<0.0001, 0.027, <0.0001 respectively. There was a significant linear correlation between CRCT and lipid and caloric contents r=0. 827, p< 0.003, r=.798, p<0.006 respectively. The linear regression equations for lipid and caloric estimation were Lipids [g/L] 1.268 + 6.497CRCT and Calories 213.07+53.287 CRCT respectively. CRCT is a simple and reliable technique for energy assessment that can be performed in every NICU. Preterm'BM is deficient in lipids and calories. Hind-milk is higher in lipids and calories compared to foremilk. Since there is a big variability among samples, we recommend CRCT measurement prior to feeds and instant supplementation upon need. Standardized supplementation is not recommended