Chapter 8 Rapid measurement of human milk energy and macronutrients in the clinical setting

Human milk provides the best basis for enteral nutrition in term neonates. However, it needs to be fortified to meet the nutritional needs of more immature infants. Since its composition is highly variable, fortification with standard amounts of macronutrient may not be adequate for preterm infants. Infrared (IR) human milk analyzers serve as a means to rapidly measure macronutrient content in breast milk and allow for subsequent tailored fortification. This can help overcome the variability in human milk and improve the quality of growth of infants. Similar to other clinical analysis, good clinical and laboratory practice must be followed when using these devices. This chapter reviews reference methods for the analysis of macronutrient content and methods that can be applied in clinical routine. Underlying principles, limitations, and pitfalls of IR milk analyzers will be discussed. We will also present breast milk composition data measured by IR bedside methods and how fortification can be optimized.