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The Effect of Nutritional Additives on Anti-Infective Factors in Human Milk

Divisions of Gastroenterology and Nutrition, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas

Christine Yang

Stanford University School of Medicine, Stanford, California

Steven Rubinstein

Stanford University School of Medicine, Stanford, California

Norman J. Lewiston

Stanford University School of Medicine, Stanford, California

David K. Stevenson

Stanford University School of Medicine, Stanford, California

John A. Kerner, JR

Stanford University School of Medicine, Stanford, California

It has become a common practice to supplement human milk with a variety of additives to improve the nutritive content of the feeding for the premature infant. Twenty-two freshly frozen human milk samples were measured for lysozyme activity, total IgA, and specific IgA to Escherichia coli serotypes 01, 04, and 06. One mL aliquots were mixed with the following: 1 mL of Similac, Similac Special Care, Enfamil, Enfamil Premature Formula, and sterile water; 33 mL of Poly-Vi-Sol, 33 mg of Moducal, and 38 mg of breast-milk fortifier, and then reanalyzed. Significant decreases (41 % to 74%) in lysozyme activity were seen with the addition of all formulas; breast-milk fortifier reduced activity by 19%, while no differences were seen with Moducal, sterile water, or Poly-Vi-Sol. No differences were seen in total IgA content, but some decreases were seen in specific IgA to E. coli serotypes 04 and 06. E. coli growth was determined after 3 1/2 hours of incubation at 37°C after mixing. All cow-milk formulas enhanced E. coli growth; soy formulas and other additives preserved inhibition of bacterial growth. Nutritional additives can impair anti-infective properties of human milk, and such interplay should be considered in the decision on the feeding regimen of premature infants.

Clinical Pediatrics, Vol. 33, No. 6, 325-328 (1994)
DOI: 10.1177/000992289403300602


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