{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:01:36Z","timestamp":1777456896238,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2009,11,24]],"date-time":"2009-11-24T00:00:00Z","timestamp":1259020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Breastfeeding Medicine"],"published-print":{"date-parts":[[2010,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>It is necessary to fortify human milk to promote optimal growth of the very preterm infant. However, the addition of non-human milk components to human milk is not ideal because of the risk of feeding intolerance and necrotizing enterocolitis. Human milk products (HMP) are an alternative to commercially available fortifiers, but their preparation is likely to result in modifications to the qualities of human milk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Ten batches of HMP were prepared with the aim of meeting a desired protein:energy ratio of 3.0\u2009g of protein\/100\u2009kcal. Ultrafiltration was used to produce a skim milk concentrate, to which cream was then added to produce the final HMP. Characterization of HMP and human milk fortified with commercial human milk fortifiers (Nutriprem\n                      <jats:sup>\u00ae<\/jats:sup>\n                      [Cow &amp; Gate, Limerick, Ireland] and S-26 SMA human milk fortifier [Wyeth Nutrition, Baulkham Hills, NSW, Australia]) included quantifying macronutrient content, osmolality, microbial content, and particle distribution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Average protein:energy ratio of the final batch was 2.93\u2009\u00b1\u20090.10\u2009g of protein\/100\u2009kcal, equating to an inaccuracy of 2.5% relative to the desired ratio of 3.0\u2009g of protein\/100\u2009kcal. Significantly greater fat (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.01), lower lactose (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001), and lower osmolality (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001) were characteristic of the HMP compared to human milk fortified with either commercial fortifier. Microbial growth occurred during preparation of HMP but did not exceed 10\n                      <jats:sup>5<\/jats:sup>\n                      colony-forming units\/mL, and pasteurization of human milk prevented contamination in 80% of batches.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>HMP can be designed to accurately target the protein and energy requirements of the preterm infant, but modifications of the macronutrient, biochemical, structural, and microbial characteristics of human milk may affect the quality of the final product.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/bfm.2009.0028","type":"journal-article","created":{"date-parts":[[2009,11,24]],"date-time":"2009-11-24T22:53:45Z","timestamp":1259103225000},"page":"59-66","source":"Crossref","is-referenced-by-count":4,"title":["Design and Characterization of a Human Milk Product for the Preterm Infant"],"prefix":"10.1177","volume":"5","author":[{"given":"Charles","family":"Czank","sequence":"first","affiliation":[{"name":"The University of Western Australia","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Simmer","sequence":"additional","affiliation":[{"name":"King Edward Memorial Hospital","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter E.","family":"Hartmann","sequence":"additional","affiliation":[{"name":"The University of Western Australia","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,11,24]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"CD003517","article-title":"Optimal duration of exclusive breastfeeding","volume":"1","author":"Kramer MS","year":"2002","unstructured":"Kramer MS, , Kakuma R. 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