ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1596255
Osmolality of donor human milk rises dramatically within minutes of fortification with varied degrees depending on the fortifier used
Provisionally accepted
- Baoan Women's and Children's Hospital, Shenzhen, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: The addition of fortifiers to human milk can enhance its energy and protein content, although it results in an increase in osmolality, which may vary depending on the composition of fortifiers. The manner in which osmolality changes over time remains uncertain. Aims: We hypothesized that the impact of different fortifiers on osmolality would vary significantly and evolve dynamically with the duration of place time. Methods:Osmolality measurements were taken from the donor human milk(DHM)at 3 and 22 hours after the addition of six different human milk fortifiers (HMFs) using a freezing osmolality meter. Furthermore, the osmolality was evaluated at nine time points following the standard fortification procedure with HMF1-3. Results: (1) The mean osmolality of the unfortified donor milk was 299 mOsm/kg. The addition of three multi-component fortifiers (HMF1-3) led to a significant elevation in osmolality (P<0.05), albeit to varying extents (54.6-109.1 mOsm/kg). The addition of the preterm formula HMF4 resulted in a lesser increase in osmolality in comparison to HMF1 and HMF2. (2) The osmolality increased significantly by 183.0±27.4 mOsm/kg after the addition of the protein fortifier PF1, whereas it increased by only 8.9±2.9 mOsm/kg after the addition of PF2 (P<0.05). ( 3) The osmolality at 22 hours showed a minimal increase of 0.3-3.7 mOsm/kg (0.1-1.0%) compared to the osmolality at 3 hours following the addition of the six fortifiers. (4) The increase in osmolality following fortification with HMF1-3 was predominantly observed within two minutes of addition, accounting for 85.9-91.2% of the total increase, followed by a slow increase over the subsequent 12 hours, with a slight decrease thereafter. Conclusions: The addition of fortifiers significantly increased the osmolality of DHM. However, the degree of increase varied depending on the nutrient composition and content of the fortifiers used. It remains a challenge to avoid the rapid increase in osmolality of DHM within a very short time after the addition of a fortifier, even when fortifying at the bedside.
Keywords: Donor human milk, Human milk fortifier, Osmolality, protein fortifier, preterm infants
Received: 19 Mar 2025; Accepted: 23 May 2025.
Copyright: © 2025 Tang, Yin, Jin, Zhang and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ping Zhou, Baoan Women's and Children's Hospital, Shenzhen, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.