{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T10:43:25Z","timestamp":1784025805765,"version":"3.55.0"},"reference-count":20,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T00:00:00Z","timestamp":1622851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swedish Research Council funding for clinical research in medicine (ALF)","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The objective of this study was to investigate factors influencing fat loss during tube feeding of breast milk to preterm infants. An experimental study with 81 feeding simulations was performed, with nine continuous infusions in each of six modalities: Horizontal Higher, Horizontal Matched, Horizontal Lower, Tilted Higher, Tilted Matched, and Tilted Lower, and for comparison, 27 bolus feedings: nine flushed with air, nine with water, and nine that were not flushed, done at matched height. Each simulation utilized 16 mL of breast milk given over four hours. Continuous infusions were given with a flow rate of 4 mL\/h. Bolus was given as 8 mL over the course of 15\u201320 min every other hour. Analysis for fat, true protein, carbohydrate, total solids, and energy was performed before and after each simulation. The percent of macronutrient loss was compared between all simulations. Continuous infusion resulted in an average fat loss of 40%. Bolus feedings resulted in an average fat loss of 11% (p \u2264 0.001). Considerable fat loss is seen during continuous tube feeding. Neither height in relation to the infant nor tilting of the pump reduce fat loss. To limit fat loss, the bolus feeding method should be utilized.<\/jats:p>","DOI":"10.3390\/nu13061939","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T01:56:40Z","timestamp":1623031000000},"page":"1939","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Factors Influencing Breast Milk Fat Loss during Administration in the Neonatal Intensive Care Unit"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2514-6618","authenticated-orcid":false,"given":"Mattias","family":"Paulsson","sequence":"first","affiliation":[{"name":"Department of Children\u2019s and Women\u2019s Health, Uppsala University Hospital, SE 751 85 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Jacobsson","sequence":"additional","affiliation":[{"name":"Department of Children\u2019s and Women\u2019s Health, Uppsala University Hospital, SE 751 85 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Ahlsson","sequence":"additional","affiliation":[{"name":"Department of Children\u2019s and Women\u2019s Health, Uppsala University Hospital, SE 751 85 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1542\/peds.111.5.986","article-title":"Extrauterine Growth Restriction Remains a Serious Problem in Prematurely Born Neonates","volume":"1","author":"Clark","year":"2003","journal-title":"Pediatrics"},{"key":"ref_2","first-page":"453","article-title":"Risk Factors for Extrauterine Growth Restriction in Preterm Infants with Gestational Age Less than 34 Weeks","volume":"5","author":"Cao","year":"2015","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1007\/s00431-008-0885-9","article-title":"Extrauterine Growth Retardation in Premature Infants in Shanghai: A Multicenter Retrospective Review","volume":"9","author":"Shan","year":"2009","journal-title":"Eur. J. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/S0146-0005(03)00044-2","article-title":"Growth Failure in the Preterm Infant: Can We Catch Up?","volume":"4","author":"Dusick","year":"2003","journal-title":"Semin. Perinatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1542\/peds.107.2.270","article-title":"Postnatal malnutrition and growth retardation: An inevitable consequence of current recommendations in preterm infants?","volume":"2","author":"Embleton","year":"2001","journal-title":"Pediatrics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1111\/apa.13958","article-title":"Nonrandomised Interventional Study Showed That Early Aggressive Nutrition Was Effective in Reducing Postnatal Growth Restriction in Preterm Infants","volume":"10","author":"Genoni","year":"2017","journal-title":"Acta Paediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6213","DOI":"10.3390\/nu7085279","article-title":"The Fate of Fat: Pre-Exposure Fat Losses during Nasogastric Tube Feeding in Preterm Newborns","volume":"8","author":"Rayyan","year":"2015","journal-title":"Nutrients"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1136\/adc.53.4.344","article-title":"Loss of Energy during Continuous Infusions of Breast Milk","volume":"4","author":"Brooke","year":"1978","journal-title":"Arch. Dis. Child."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1136\/adc.59.5.475","article-title":"Fat Loss during Feeding of Human Milk","volume":"5","author":"Narayanan","year":"1984","journal-title":"Arch. Dis. Child."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1136\/adc.60.2.164","article-title":"Loss of Breast Milk Nutrients during Tube Feeding","volume":"2","author":"Stocks","year":"1985","journal-title":"Arch. Dis. Child."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1136\/adc.2008.153577","article-title":"Loss of Triglycerides and Carotenoids in Human Milk after Processing","volume":"94","author":"Tacken","year":"2009","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/ANC.0b013e31827e225b","article-title":"Comparison of Lipid and Calorie Loss from Donor Human Milk among 3 Methods of Simulated Gavage Feeding: One-Hour, 2-Hour, and Intermittent Gravity Feedings","volume":"2","author":"Brooks","year":"2013","journal-title":"Adv. Neonatal Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1002\/jpen.1430","article-title":"Energy and Fat Intake for Preterm Infants Fed Donor Milk Is Significantly Impacted by Enteral Feeding Method","volume":"1","author":"Castro","year":"2019","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.earlhumdev.2011.04.016","article-title":"Analysis of the influence of pasteurization, freezing\/thawing, and offer processes on human milk\u2019s macronutrient concentrations","volume":"8","author":"Vieira","year":"2011","journal-title":"Early Hum. Dev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.jpeds.2005.03.003","article-title":"Continuous Feeding Promotes Gastrointestinal Tolerance and Growth in Very Low Birth Weight Infants","volume":"1","author":"Dsilna","year":"2005","journal-title":"J Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/AJP.0b013e3181633fd6","article-title":"Behavioral Stress Is Affected by the Mode of Tube Feeding in Very Low Birth Weight Infants","volume":"5","author":"Dsilna","year":"2008","journal-title":"Clin. J. Pain"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/S0022-3476(96)70324-4","article-title":"A Prospective Randomized Trial Comparing Continuous versus Intermittent Feeding Methods in Very Low Birth Weight Neonates","volume":"6","author":"Silvestre","year":"1996","journal-title":"J. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Zozaya, C., Garc\u00eda-Serrano, A., Fontecha, J., Redondo-Bravo, L., S\u00e1nchez-Gonz\u00e1lez, V., Montes, M.T., and Saenz de Pipa\u00f3n, M. (2018). Fat Loss in Continuous Enteral Feeding of the Preterm Infant: How Much, What and When Is It Lost?. Nutrients, 10.","DOI":"10.20944\/preprints201806.0119.v1"},{"key":"ref_19","unstructured":"(2021, May 31). Neonatal Intensive Care Units (NICUs). Available online: https:\/\/www.mirissolutions.com\/our-customers\/neonatal-intensive-care-unit."},{"key":"ref_20","first-page":"436","article-title":"Type of Homogenization and Fat Loss during Continuous Infusion of Human Milk","volume":"4","year":"2014","journal-title":"J. Hum. Lact."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/6\/1939\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:11:09Z","timestamp":1760163069000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/6\/1939"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,5]]},"references-count":20,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["nu13061939"],"URL":"https:\/\/doi.org\/10.3390\/nu13061939","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,5]]}}}