Evaluation of Fat Separation and Removal Methods to Prepare Low‐Fat Breast Milk for Fat‐Intolerant Neonates With Chylothorax

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Abstract
Background: The purpose of this study was to compare 2 methods (syringe and spoon methods) of removing the fat from the low‐fat milk portion and compare 3 methods (refrigerated centrifuge, nonrefrigerated centrifuge, and refrigeration method) of separating breast milk into the fat and low‐fat milk components. Methods: Human milk was divided into 24 aliquots using the 3 separating methods, and 2 methods (syringe, spoon) were compared to extract the low‐fat milk. Thirty‐one human milk samples were separated into fatty and low‐fat milk layers using 3 methods: 24‐hour refrigerator storage (2°C), centrifuged at 3000 rpm for 15 minutes at room temperature, and spun in the refrigerated‐centrifuge at 3000 rpm for 15 minutes at 2°C. After 24 hours of refrigeration, a syringe was used to remove the low‐fat milk. Triglycerides were analyzed before and after separation and removal methods. Results: For fat removal, the syringe method (1.2 g/dl, 95% confidence interval [CI], 1.1‐1.4, fat content) left 34% less residual fat compared to the spoon method (1.9 g/dl, 95% CI, 1.5‐2.3); this difference did not reach statistical significance (P = .065). For fat separation, the centrifuge methods (mean: 1.0 g/dl, 95% CI, 0.8‐1.1) left significantly less residual fat than the refrigerator method (3.4 g/dl, 95% CI, 3.0‐3.7; P < .0001). Conclusion: Using the syringe vs a spoon at removing the milk from the fat, although not statistically significant, was likely of clinical importance. A centrifuge was more effective at separating the fat in human milk.

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