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Im Rahmen einer webbasierten Onlinebefragung wird die derzeitige Praxis der Diagnostik und Therapie der KMPA bei osterreichischen Padiatern erhoben. Erstmals gibt es damit fur Osterreich Daten zur Diagnostik und Therapie, sowie zur Verordnungs- und Bewilligungspraxis von Therapeutika der KMPA. Es finden sich deutliche Defizite und Diskrepanzen zu den derzeitig gultigen Empfehlungen, die zur Durchfuhrung von nicht notwendigen, nicht empfohlenen Laborbestimmungen fuhren. Die orale Provokation mit Kuhmilch nach erfolgreicher klinischer Symptomverbesserung und die Verordnung von nicht evidenzbasierten Nahrungen sind durchaus haufig zu finden. Die Bewilligungspraxis durch die Krankenkassen wird vonseiten vieler Arzte als unbefriedigend, uneinheitlich und nicht klar geregelt empfunden

Aim This study measured the composition of preterm human breastmilk, particularly the protein content, with the MIRIS Human Milk Analyser, compared our results with published values and determined the relationship between protein content and lactation period. Methods We analysed 83 samples of 24-hour pooled human milk from 76 mothers who delivered preterm infants weighing under 1500 g at less than 32 weeks of gestational age. The milk's protein, fat and energy were measured by the MIRIS Human Milk Analyser and compared to reference values. The relationship between protein content and lactation period was quantified. Results On average, the samples contained 1.1 ± 0.37 g (0.2–2.2 g) of protein, 3.2 ± 0.85 g (range 1.1–6.1 g) of fat, 6.6 ± 0.34 g of lactose (5.5–8.0 g) and 60 ± 11 kcal (39–94 kcal) of energy per 100 mL. The wide variations in macronutrient content were not influenced by the gestational age of the infant and the lactation day results from 70 of the mothers correlated inversely with the protein content (p < 0.0001; r = −0.42). The MIRIS proved useful, but some adjustments are needed. Conclusion Variations in macronutrients were high in the breastmilk of women who delivered preterm babies and the protein content decreased with lactation. With adjustments, the MIRIS might provide a helpful tool for individualised fortification.

Background Human milk (HM) is unique and the gold standard for feeding preterm infants. However, HM contains insufficient quantity of energy, calcium, phosphorus and protein - the key nutrient - for preterm infants. Low protein intake is associated with poor weight gain, length and neurocognitive outcomes. Therefore, human milk fortifiers have been developed. The aim of Compo-HMA study was to measure the composition and variation in preterm HM, the impact of lactation period and different milk processing types on the nutritional content with MIRIS Human Milk Analyzer (HMA). Methods HM was taken from mothers of premature infants born with a birthweight

Background and Aims A new additional protein supplement (Aptamil Protein+®/Milupa) was developed to meet special protein requirements of infants with a birthweight below 1000g (4.0–4.5 g protein/kg/day). So far it was unknown, how this new protein supplement influences osmolarity, which is known to be a risk factor for necrotising enterocolitis (NEC). The aim of this study was to evaluate the effects of fortification on the osmolarity of human milk (HM). Methods Osmolarity of breast milk was measured in native HM, in HM+ HMF (human milk fortifier; Aptamil FMS 4.3%®, Milupa) and in HM+ HMF+ Protein+ gaining in 0.5 g steps up to 4 g. Measurements were performed immediately after adding on fortifier and/or protein and after 24 hours. In addition, changes in osmolarity after adding therapeutic additives like iron (Ferrum Hausmann®, Vifor), multivitamine supplement (Protovit®, Bayer) and calcium-phosphorus capsules were measured. Results Osmolarity of native human milk (n=84) was 297mosm/l, (=Median, Range 278–348). Adding HMF increased osmolarity up to 436mosm/l (=Median; Range 386–486). Additional Protein+ supplementation increased osmolarity by 23.5mosm/l (Median) per 0.5g step, up to a maximum of 605 mosm/l (+4g). Osmolarity of HM/fortifier/Protein+ mixes remained stable for 24 hours. Multivitamin supplements increased osmolarity up to 842mosm/l. Discussion Additional Protein+ increased osmolarity of HM up to a critical cut off point (>400mosmol) and therefore might be a risk factor for developing NEC. Additional fortification of HM +HMF with Protein+ should not be applied together with multivitamins or other additives.

Human milk (HM) is unique and the gold standard for feeding neonates. HM contains insufficient quantity of protein for preterm infants. Therefore, a new supplement (Aptamil Protein+®-Milupa/Danone) was developed.