{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:11:02Z","timestamp":1790817062457,"version":"4.1.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Human milk (HM) fortification has been recommended for the nutritional optimization of very low\u2013birthweight infants. This study analyzed the bioactive components of HM and evaluated fortification choices that could accentuate or attenuate the concentration of such components, with special reference to human milk-derived fortifier (HMDF) offered to extremely premature infants as an exclusive human milk diet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      An observational feasibility study analyzed the biochemical and immunochemical characteristics of mothers' own milk (MOM), both fresh and frozen, and pasteurized banked donor human milk (DHM), each supplemented with either HMDF or cow's milk-derived fortifier (CMDF). Gestation-specific specimens were analyzed for macronutrients, pH, total solids, antioxidant activity (AA),\n                      <jats:italic toggle=\"yes\">\u03b1<\/jats:italic>\n                      -lactalbumin, lactoferrin, lysozyme, and \u03b1- and\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      -caseins. Data were analyzed for variance applying general linear model and Tukey's test for pairwise comparison.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      DHM exhibited significantly lower (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) lactoferrin and \u03b1-lactalbumin concentrations than fresh and frozen MOM. HMDF reinstated lactoferrin and \u03b1-lactalbumin and exhibited higher protein, fat, and total solids (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) in comparison to unfortified and CMDF-supplemented specimens. HMDF had the highest (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) AA, suggesting the potential capability of HMDF to enhance oxidative scavenging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      DHM, compared with MOM, has reduced bioactive properties, and CMDF conferred the least additional bioactive components. Reinstatement and further enhancement of bioactivity, which has been attenuated through pasteurization of DHM, is demonstrated through HMDF supplementation. Freshly expressed MOM fortified with HMDF and given\n                      <jats:italic toggle=\"yes\">early<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">enterally<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">exclusively (3E)<\/jats:italic>\n                      appears an optimal nutritional choice for extremely premature infants.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/bfm.2022.0254","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T13:28:35Z","timestamp":1681824515000},"page":"279-290","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Exclusive Human Milk Diet for Extremely Premature Infants: A Novel Fortification Strategy That Enhances the Bioactive Properties of Fresh, Frozen, and Pasteurized Milk Specimens"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6097-9869","authenticated-orcid":false,"given":"Roy K.","family":"Philip","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University Maternity Hospital Limerick (UMHL), Limerick, Ireland."},{"name":"University of Limerick School of Medicine, Limerick, Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2254-2866","authenticated-orcid":false,"given":"Ehab","family":"Romeih","sequence":"additional","affiliation":[{"name":"Department of Chemical Sciences and Bernal Institute, University of Limerick, Limerick, Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Bailie","sequence":"additional","affiliation":[{"name":"Milk Bank, Western Health &amp; Social Care Trust, Enniskillen, Northern Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy","family":"Daly","sequence":"additional","affiliation":[{"name":"Advocacy and Policymaking, Irish Neonatal Health Alliance (INHA), Wicklow, Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran D.","family":"McGourty","sequence":"additional","affiliation":[{"name":"Department of Chemical Sciences and Bernal Institute, University of Limerick, Limerick, Ireland."},{"name":"Bernal Institute, University of Limerick, Limerick, Ireland."},{"name":"Health Research Institute (HRI), University of Limerick, Limerick, Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas M.","family":"Grabrucker","sequence":"additional","affiliation":[{"name":"Bernal Institute, University of Limerick, Limerick, Ireland."},{"name":"Health Research Institute (HRI), University of Limerick, Limerick, Ireland."},{"name":"Department of Biological Sciences, University of Limerick, Limerick, Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colum P.","family":"Dunne","sequence":"additional","affiliation":[{"name":"University of Limerick School of Medicine, Limerick, Ireland."},{"name":"Center for Interventions in Infection, Inflammation, and Immunity (4i), University of Limerick School of Medicine, Limerick, Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Chemical Sciences and Bernal Institute, University of Limerick, Limerick, Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,4,14]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30451-0"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2012.0067"},{"issue":"1","key":"e_1_3_8_4_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1542\/peds.2016-3440","article-title":"Donor human milk for the high-risk infant: Preparation, safety, and usage options in the United States","volume":"139","author":"Committee on Nutrition","year":"2017","unstructured":"Committee on Nutrition, , Section on Breastfeeding, , Committee on Fetus and Newborn. 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