{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:15:24Z","timestamp":1788239724989,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JPGN rep."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chylothorax in infants is a potentially life\u2010threatening condition, often resulting from injury during cardiac surgery. Traditionally, breastfeeding is discontinued. Recently, feeding with defatted human milk has been safely introduced. However, methods for fat reintroduction are not standardized. We developed a mathematical formula to facilitate individualized, progressive reintroduction of fat into skimmed breast milk. Fat and protein content were analyzed by Fourier\u2010transform infrared spectroscopy (FTIR). Defatting was performed by centrifugation at 3000\u2009rpm at 2\u00b0C for 15\u2009min. The formula considers: fat concentration of unmodified human milk and defatted milk, target fat concentration, and milk volume. Clinical application in a premature infant showed effective fat reintroduction (0.2\u2009g\/dL every 48\u2009h), with no recurrence of chylothorax. Some factors influenced milk defatting. Breast milk provides important immunological and functional benefits. Our formula supports safe administration and can assist in designing further studies to determine optimal daily fat increments.<\/jats:p>","DOI":"10.1002\/jpr3.70235","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:23:07Z","timestamp":1788236587000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Formula for the progressive reintroduction of fat into breast milk in infants with chylothorax"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1486-9041","authenticated-orcid":false,"given":"Sonia Mar\u00eda","family":"Alonso\u2010Clemente","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics \u00c1lvaro Cunqueiro University Hospital Vigo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0846-2192","authenticated-orcid":false,"given":"Ana","family":"Concheiro\u2010Guisan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics \u00c1lvaro Cunqueiro University Hospital and Galicia Sur Health Research Institute Vigo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"issue":"4","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.siny.2017.03.005","article-title":"Congenital chylothorax","volume":"22","author":"Attar MA","year":"2017","journal-title":"Semin Fetal Neonatal Med"},{"issue":"9","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","DOI":"10.3390\/nu14091803","article-title":"Postoperative chylothorax in neonates and infants after congenital heart disease surgery","volume":"14","author":"Samanidis G","year":"2022","journal-title":"Nutrients"},{"issue":"1","key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1159\/000518217","article-title":"Congenital chylothorax of the newborn: a systematic analysis of published cases between 1990 and 2018","volume":"101","author":"Resch B","year":"2022","journal-title":"Respiration"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/bs.ircmb.2017.12.002","article-title":"The lymphatic fluid","volume":"337","author":"Santambrogio L","year":"2018","journal-title":"Int Rev Cell Mol Biol"},{"issue":"8","key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1111\/jpc.13889","article-title":"Octreotide for congenital and acquired chylothorax in newborns: a systematic review","volume":"54","author":"Bellini C","year":"2018","journal-title":"J Paediatr Child Health"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","DOI":"10.1186\/1749-8090-5-127","article-title":"Chylothorax after surgery on congenital heart disease in newborns and infants: risk factors and efficacy of MCT\u2010diet","volume":"5","author":"Biewer ES","year":"2010","journal-title":"J Cardiothorac Surg"},{"issue":"2","key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1177\/0148607108314758","article-title":"Effects of medium\u2010chain triglycerides, long\u2010chain triglycerides, or 2\u2010monododecanoin on fatty acid composition in the portal vein, intestinal lymph, and systemic circulation in rats","volume":"32","author":"You YQ","year":"2008","journal-title":"JPEN J Parenter Enteral Nutr"},{"issue":"9","key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1089\/bfm.2019.0100","article-title":"The practicality of feeding defatted human milk in the treatment of congenital chylothorax","volume":"14","author":"Concheiro\u2010Guisan A","year":"2019","journal-title":"Breastfeed Med"},{"issue":"4","key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1177\/0148607114566464","article-title":"Fat\u2010modified breast milk resolves chylous pleural effusion in infants with postsurgical chylothorax but is associated with slow growth","volume":"40","author":"Kocel SL","year":"2016","journal-title":"JPEN J Parenter Enteral Nutr"},{"issue":"1","key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/s00246-019-02230-z","article-title":"ChyloBEST: chylothorax in infants and nutrition with low\u2010fat breast milk","volume":"41","author":"Neumann L","year":"2020","journal-title":"Pediatr Cardiol"},{"key":"e_1_2_7_12_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.clnesp.2020.05.001","article-title":"Growth of cardiac infants with post\u2010surgical chylothorax can be supported using modified fat breast milk with proactive nutrient\u2010enrichment and advancement feeding protocols; an open\u2010label trial","volume":"38","author":"DiLauro S","year":"2020","journal-title":"Clin Nutr ESPEN"},{"issue":"8","key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1017\/S1047951122001871","article-title":"Development of consensus recommendations for the management of post\u2010operative chylothorax in paediatric CHD","volume":"32","author":"Lion RP","year":"2022","journal-title":"Cardiol Young"},{"issue":"11","key":"e_1_2_7_14_1","doi-asserted-by":"crossref","DOI":"10.1093\/cdn\/nzz116","article-title":"Accuracy and reliability of infrared analyzers for measuring human milk macronutrients in a milk bank setting","volume":"3","author":"Perrin MT","year":"2019","journal-title":"Curr Dev Nutr"},{"issue":"11","key":"e_1_2_7_15_1","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1089\/bfm.2024.0249","article-title":"Fat content and energy calculation in pasteurized human milk: comparison between infrared analysis and creamatocrit method","volume":"19","author":"Andreassa NP","year":"2024","journal-title":"Breastfeed Med"},{"issue":"9","key":"e_1_2_7_16_1","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1017\/S1047951119001525","article-title":"British Dietetic Association Paediatric Cardiology Interest Group. An international survey of the nutrition management of chylothorax: a time for change","volume":"29","author":"Marino LV","year":"2019","journal-title":"Cardiol Young"},{"issue":"5","key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1177\/0884533613497763","article-title":"Evaluation of fat separation and removal methods to prepare low\u2010fat breast milk for fat\u2010intolerant neonates with chylothorax","volume":"28","author":"Drewniak MA","year":"2013","journal-title":"Nutr Clin Pract"},{"issue":"7","key":"e_1_2_7_18_1","article-title":"Is increased fat content of hindmilk due to the size or the number of milk fat globules?","volume":"4","author":"Pawelczyk M","year":"2009","journal-title":"Int Breastfeed J"},{"issue":"5","key":"e_1_2_7_19_1","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1177\/0884533617722762","article-title":"Immunoglobulin A and protein content of low\u2010fat human milk prepared for the treatment of chylothorax","volume":"33","author":"Drewniak M","year":"2018","journal-title":"Nutr Clin Pract"},{"key":"e_1_2_7_20_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.lwt.2022.114184","article-title":"The effect of pasteurization treatment and skimming conditions on human milk proteins","volume":"172","author":"Gharbi N","year":"2022","journal-title":"LWT\u2010Food Sci Technol"},{"issue":"1","key":"e_1_2_7_21_1","first-page":"41","article-title":"Fortification of human milk for preterm infants: update and recommendations","volume":"39","author":"Arslanoglu S","year":"2019","journal-title":"J Perinatol"}],"container-title":["JPGN Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpr3.70235","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jpr3.70235","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpr3.70235","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:23:10Z","timestamp":1788236590000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jpr3.70235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":20,"alternative-id":["10.1002\/jpr3.70235"],"URL":"https:\/\/doi.org\/10.1002\/jpr3.70235","archive":["Portico"],"relation":{},"ISSN":["2691-171X","2691-171X"],"issn-type":[{"value":"2691-171X","type":"print"},{"value":"2691-171X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"assertion":[{"value":"2026-01-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jpr3.70235"}}