Macronutrient analysis of donor human milk labelled as 24 kcal/oz

Objective: To measure the macronutrient content (MNC) of donor human milk labelled as 24 kcal/oz (“high-calorie DHM,” hcDHM), compare to bank-labelled MNC, and examine variability of hcDHM MNC among milk banks. Study design: MNC was measured with near-infrared spectroscopy for 75 convenience samples from five milk banks collected during September 2016–July 2017. Concordance of measured MNC with labelled values was evaluated using three different thresholds: within ±20%, similar to FDA labelling standards for class II nutrients in foods; ±10%; and ±5%. Results: Protein and caloric content differed significantly between measured and labelled values and varied significantly among milk banks. Measured caloric content ranged from 16.50 to 30.27 kcal/oz, with 89.3% of hcDHM samples within ±20%, 58.7% within ±10%, and 18.7% within ±5% of labelled content. Conclusions: MNC of hcDHM used in clinical practice shows variation that may result in differences from desired diet. The clinical implications of such differences are unexplored.