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Changes in macronutrients of human milk after bolus feeding: a simulation study



Enteral nutrition supply to preterm infants requires feeding through a feeding tube. The aim of this study was to evaluate changes in macronutrient composition of human milk (HM) while passing through a gastric feeding tube.


Simulated real-life practice tube feeding was performed by using an infusion pump connected to a feeding tube. A human milk analyzer was used to compare the pre infusion and post infusion macronutrient contents of HM.


There was a significant decrease in fat (from 4.06 ± 0.6 g/100 ml to 3.95 ± 0.6 g/100 ml), carbohydrates (from 7.51 ± 0.4 g/100 ml to 7.33 ± 0.5 g/100 ml), and energy content (from 70.77 ± 5.4 kcal/100 ml to 69.72 ± 0.5 kcal/100 ml) after passing through the feeding tube (P < 0.001).


A simulated real-life bolus tube feeding model demonstrated small but significant decreases in fat, carbohydrate, and energy content. The biological significance of our results to the very low birth weight infants should be further studied.

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Fig. 1: Macronutrients content before and after passage through a nasogastric feeding tube.


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Author information




DM, FBM, and RL conceptualized and designed the study and reviewed and revised the manuscript. HM-L and IZ designed the data collection instruments, collected data, carried out the initial analyses, drafted the initial manuscript, and reviewed and revised the manuscript. LM conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Hadar Moran-Lev.

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The authors declare that they have no conflict of interest.


This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the Helsinki ethics committee. The study protocol was approved by the institutional review board of the medical center (0062-11). A signed written informed consent was obtained from all the participating mothers.

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Zommerfroind, I., Moran-Lev, H., Mandel, D. et al. Changes in macronutrients of human milk after bolus feeding: a simulation study. J Perinatol 41, 1069–1073 (2021).

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