BN-R12

Human milk digestion in the preterm infant

Human milk is preferentially fed to very low birth weight infants. When mother’s milk is not available, human milk from milk bank can be administered after pasteurization. Our objective was to evaluate the impact of the technological treatments on the digestive behaviour of human milk.

Pasteurization of human milk (62.5°C, 30 min), ensuring sanitary quality, denatures lipases. On the opposite, homogenization, by increasing the specific surface of the fat droplets, could improve lipolysis.

We evaluated the impact of these technological treatments on the gastric digestive behaviour of human milk over 20 preterm infants through their feeding tube (clinical trial ethically approved NCT02112331).

  • Pasteurization did not impact gastric lipolysis
  • Homogenization doubled the degree of lipolysis of the pasteurized milk
  • Enzymatic activity of lipases in gastric effluents tended to be higher after ingestion of raw milk compared to pasteurized and homogenized milks
  • Both treatments affected the microstructure of the human milk, and this was maintained during digestion.
BN-R12_image

 Confocal laser scanning microscopy images of human milk as raw (1), pasteurized (2), pasteurized and homogenized (3) coloured by fluorescent probes (green : apolar lipids, red : amphiphilic molecules; blue : proteins).

Our results provide essential knowledge for supporting the challenging decisions in clinical practices and nutritional interventions for preterm infants. Homogenization could be a strategy for improving growth in preterm infants.