Essential and toxic elements in human milk concentrate with human milk lyophilizate: A preclinical study

Mariana M Oliveira; Tânia M B Trevilato; Susana I Segura-Muñoz; Davi C Aragon; Larissa G Alves; Martí Nadal; Montse Marquès; José L Domingo; Jordi Sierra; José Simon Camelo Jr

doi:10.1016/j.envres.2020.109733

Essential and toxic elements in human milk concentrate with human milk lyophilizate: A preclinical study

Environ Res. 2020 Sep:188:109733. doi: 10.1016/j.envres.2020.109733. Epub 2020 Jun 1.

Affiliations

¹ Department of Pediatrics, Childreńs Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
² Section of Metals and Rare Diseases, Laboratory of Pediatrics, Clinics Hospital of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
³ Laboratory of Ecotoxicology and Environmental Parasitology, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
⁴ Human Milk Bank, Clinics Hospital of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
⁵ Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira I Virgili, Reus, Catalonia, Spain.
⁶ Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira I Virgili, Reus, Catalonia, Spain; Laboratory of Soil Science, Faculty of Pharmacy, Universitat de Barcelona, Catalonia, Spain.
⁷ Department of Pediatrics, Childreńs Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. Electronic address: [email protected].

Abstract

Concentrated human milk (HM-concentrate) can be obtained from the simple and inexpensive method of donated breast milk direct lyophilization. A previous study reported that HM-concentrate contains the adequate amount of main macro- and micronutrients for use as a nutritional resource for preterm infants with very low birth weight admitted to neonatal intensive care units. However, further details need to be elucidated about HM-concentrate composition, particularly its content of essential and potentially toxic trace elements. Therefore, this study aimed to determine the concentration of essential and toxic elements in human milk considered baseline (HM-baseline) and HM-concentrate, as well as to quantify changes in concentration of these elements after the HM concentration process. The concentration of Aluminum, Arsenic, Cadmium, Chromium, Iron, Mercury, Manganese, Nickel, Lead, Selenium, Tin, and Thallium was analyzed by inductively coupled plasma-mass spectrometry (ICP-MS). Moreover, Bayesian linear mixed effect models were applied to estimate the mean difference between HM-baseline and HM-concentrate samples. After comparison (HM-concentrate versus HM-baseline), a significant increase in concentration was observed only for Manganese (0.80 μg/L; 95% CrI [0.16; 1.43]) and Selenium (6.74 μg/L; 95% CrI [4.66; 8.86]), while Lead concentration (-6.13 μg/L; 95% CrI [-8.63; -3.61]) decreased. This study provides latest and reliable information about HM composition. After milk concentration by lyophilization, there was a significant increase only in the essential elements Manganese and Selenium. The essential micronutrient content in HM-concentrate was similar or higher than that in preterm mothers' milk, which suggests it is viable for nutritional support of preterm infants. In addition, the low concentrations of potentially toxic elements in HM-concentrate indicates that it is safe for consumption by premature newborns.

Keywords: Biomonitoring; Breast milk; Human milk; Micronutrients; Premature infant.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Animals
Bayes Theorem
Female
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Milk, Human* / chemistry
Trace Elements* / analysis

Substances

Trace Elements